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【目的】探讨霉酚酸酯（MMF）联合他克莫司（TAC）治疗激素抵抗型肾病综合征（SRNS）的疗效、不良反应。【方法】收集SRNS患者74例，其中微小病变（MCD）32例、局灶节段性肾小球硬化（FSGS）22例、弥漫性系膜增生（DMP）20例，所有患者采用 MMF 1 g/d和糖皮质激素50 mg（隔日一次）治疗（第一步治疗）；第一步治疗仍未实现临床缓解的患者，则自动进入第二步治疗方案，即停用激素，采用MMF 1 g/d联合T AC 3 mg/d治疗6个月，观察不同治疗方案和病理类型的疗效及不良反应。【结果】74例SRNS患者接受第一步治疗，24例（32．4％）患者达到完全缓解，4例（5．4％）部分缓解；余下46例未出现临床缓解的患者停用激素，接受第二步治疗，22例（47．8％）患者达到完全缓解，4例（8．7％）患者达到部分缓解。不同病理类型缓解率比较有显著性差异（ P＜0．05），其中MCD缓解率最高，FSGS缓解率最低。治疗过程中所有患者均无明显不良反应。【结论】MMF联合TAC治疗SRNS ，疗效满意，值得临床推广应用。“,”[Objective]To explore the efficacy and adverse reaction of mycophenolate mofetil (MMF) com-bined with tacrolimus(TAC) for the treatment of steroid-resistant nephrotic syndrome(SRNS) .[Methods]To-tally 74 SRNS patients were collected .Pathological types included 32 cases of minimal lesion(MCD) ,22 cases of local segmental glomerulosclerosis (FSGS ) and 20 cases of diffuse mesangial proliferation (DM P ) .All pa-tients were treated with MMF 1g/day and prednisolone 50mg(alternate day) for 6 months(first-step treat-ment) .For the patients without clinical remission after the first-step treatment automatically received the sec-ond-step treatment i .e .the withdrawal of steroids and then MMF 1g/day combined with TAC 3mg/day for 6 months .The efficacy of different therapy methods ,pathological types and adverse reaction were observed .[Results]In 74 SRNS patients receiving the first-step treatment ,24 patients(32 .4% ) got complete remission , and 4 patients(5 .4% ) got partial remission ,and the other 46 patients did not get clinical remission and then stopped steroids and received the second treatment .Among these 46 patients ,22 patients(47 .8% ) got com-plete remission and 4 patients(8 .7% ) got partial remission .There was significant difference in the remission rate among different pathological types ( P <0 .05) .The remission rate of MCD was the highest and that of FSGS was the lowest .No obvious adverse reaction was found in all patients during the therapy .[Conclusion]MMF combined with TAC for the treatment of SRNS has satisfactory effect ,so it is worthy of clinical promo-tion .