蛋白尿是儿童肾脏疾病常见症状之一，目前儿科临床对于蛋白尿的分类缺乏统一的认识，对蛋白尿的诊断也 尚没有清晰的思路。文章就蛋白尿的分类和诊断思路进行归纳、整理，提出广义、狭义蛋白尿的概念，以及定性、定量、定位、 定因四步法蛋白尿的诊断思路，特别指出尿α1微球蛋白与微量白蛋白比值接近或大于1，可以作为小分子蛋白尿的判断 标准用于蛋白尿的定位诊断。

Proteinuria is one of the common symptoms of kidney disease in children. At present, there is neither unanimous understanding of the classification of proteinuria, nor clear thoughts of diagnosis of proteinuria in pediatrics. This paper summarizes and organizes the classification and diagnosis of proteinuria, and proposes the concept of proteinuria in a broad and narrow sense, as well as the four-step diagnosis idea of qualitative, quantitative, location， and cause determination. It especially points out that the ratio of α 1 microglobulin to microalbumin close to or greater than 1 in urine can be used as the judgment standard for the location diagnosis of proteinuria in small molecule proteinuria.