目的：探讨伴重度肾小管间质病变的系膜增生性肾小球肾炎（ＭｓＰＧＮ）的临床病理特征及有效治疗方法。方法：回顾分析５３例伴不同程度ＭｓＰＧＮ患者的临床和病理资料。结果：①ＭｓＰＧＮ患者可表现为肾病综合征、水肿和尿蛋白多＞１．５ｇ／２４ｈ，血尿少见，贫血、低渗尿常见；②易发生肾功能不全（１０例重度病变者中有３例）；③对激素治疗抵抗（重度病变组９例经激素治疗者中有５例）；④肾脏病理改变除系膜增殖外，多伴有不同程度的小球硬化等损害，其中节段硬化２例；⑤间质淋巴细胞亚群数量增加，ＣＤ＋４细胞、ＣＤ＋８细胞均增加，以ＣＤ＋８细胞为主，ＲＴ值＜１。结论：ＭｓＰＧＮ时肾功能不全发生率高，对激素治疗反应差，治疗上不应过分强调使用激素，应注意保护肾功能 Objective: To investigate the clinicopathological features and effective treatment of mesangial proliferative glomerulonephritis (MsPGN) with severe tubulointerstitial lesions. Methods: Retrospective analysis of 53 cases with different levels of MsPGN clinical and pathological data. Results: (1) Nephrotic syndrome can be manifested in patients with MSPGN, edema and urine protein more than 1.5g / 24h, rare hematuria, anemia, low permeability urine common; ② prone to renal insufficiency (3 of 10 severe lesions) ; ③ resistance to hormone therapy (severe disease group of 9 cases of hormone therapy in 5 cases); ④ renal pathological changes in addition to mesangial proliferation, more with varying degrees of hardening of the ball, etc., of which 2 cases of segmental sclerosis ; ⑤ The number of interstitial lymphocyte increased, the number of CD + 4 cells and CD + 8 cells increased, mainly in CD + 8 cells, RT value <1. Conclusion: MsPGN high incidence of renal insufficiency, poor response to hormone therapy, the treatment should not be too much emphasis on the use of hormones, should pay attention to the protection of renal function