目的 探讨儿童原发性肾病综合征（PNS）复发的相关因素及构建风险预测模型。方法 回顾性分析2013年1月至2020年1月入院诊断为PNS患儿的临床资料。随访患儿复发情况，分析影响患儿复发与频复发的危险因素，建立预测模型并进行效能评估。结果 纳入392例PNS患儿，男192例、女200例，中位年龄8.0（7.0~10.0）岁。392例患儿中复发266例（67.9%），复发患儿中频复发124例（46.6%）。多因素logistic回归分析发现，发病年龄增大是PNS患儿复发的独立保护因素（P<0.05），临床分型为肾炎型、尿蛋白转阴时间延长是独立危险因素（P<0.05）。回归方程：Logit（P）=-14.27-1.85×（发病年龄）+0.65×（临床分型）+1.71×（尿蛋白转阴时间），模型预测PNS患儿复发的ROC曲线下面积（AUC）为0.90（95%CI：0.88~0.93）。依从性不良、家长PNS疾病了解情况差是PNS患儿频复发的独立危险因素（P<0.05），初次复发时间延长是独立保护因素（P<0.05）。回归方程：Logit（P）=-0.52+0.54×（依从性）+0.51×（家长PNS疾病了解情况）-0.09×（初次复发时间），模型预测PNS患儿频复发的AUC为0.89（95%CI：0.86~0.92）。结论 PNS患儿总体复发率高，与发病年龄、肾炎型、尿蛋白转阴时间密切相关，而患儿依从性、家长PNS疾病了解情况、初次复发时间与频复发相关，应给予针对性干预措施，降低患儿复发率。

Objective To explore the related factors of recurrence and to construct a risk prediction model in children with primary nephrotic syndrome (PNS). Methods The clinical data of children diagnosed with PNS from January 2013 to January 2020 were retrospectively analyzed. The recurrence of PNS children was followed up, the risk factors affecting recurrence and frequent recurrence were analyzed, the prediction model was established and its efficacy was evaluated. Results A total of 392 children with PNS (192 boys and 200 girls) were included and the median age was 8.0(7.0-10.0) years old. Among the 392 children, 266 (67.9%) had recurrence and 124 (46.6%) had frequent recurrence. Multivariate logistic regression analysis showed that the increase of onset age was an independent protective factor for the recurrence of PNS (P<0.05), and nephritis type and the prolonged time of urinary protein turning negative were independent risk factors for the recurrence of PNS (P<0.05). The regression equation was as follows: Logit (P)= -14.27-1.85× (onset age) +0.65× (clinical type) +1.71× (negative conversion time of urine protein), and the area under the receiver operating characteristic (ROC) curve (AUC) by the model was 0.90 (95%CI: 0.88-0.93). Poor compliance and poor parents' understanding of PNS were independent risk factors for frequent recurrence of PNS (P<0.05), and prolonged first recurrence time was an independent protective factor for frequent recurrence of PNS (P<0.05). The regression equation was as follows: Logit (P)= -0.52+0.54×(compliance)+0.51× (parental cognition to PNS) -0.09 × (first recurrence time), and the AUC predicting frequent recurrence in children with PNS was 0.89 (95%CI: 0.86-0.92). Conclusions The overall recurrence rate of PNS children is high, which is closely related to the age of onset, nephritis type and negative conversion time of urine protein, while children's compliance, parental cognition to PNS and first recurrence time are related to frequent recurrence. Targeted intervention measures should be given to reduce the recurrence rate of children.