【Abstract】Objective To study the effect of cyclosporine a combined with methylprednisolone on severe Henoch Schonlein purpura nephritis and on proteinuria, serum soluble vascular cell adhesion molecule-1 (sVCAM-1), vascular endothelial growth factor (VEGF). Methods From March 2015 to April 2018, 86 children with severe Henoch Schonlein purpura nephritis in our hospital were selected for study. They were divided into observation group and control group by random number table method, 43 cases in each group. The control group was treated with methylprednisolone. The observation group was treated with cyclosporine A on the basis of the control group. Both groups were treated for 6 months continuously. The clinical effect, changes of inflammatory factors, immunoglobulin, urinary protein, serum VCAM-1 and VEGF before and after treatment and adverse reactions were compared between the two groups. Results The total effective rate of clinical efficacy in the observation group was 95.35%, which was significantly higher than the control group's 81.40%(P＜0.05). The levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in observation group were lower than those in control(P＜0.05). The levels of IgA, IgG and IgM in the observation group were significantly higher than those in the control group(P＜0.05). The levels of microalbuminuria(MAU), 24h urine protein, and hematuriaβ2-MG in the observation group were lower than those in the control group(P＜0.05). The levels of serum soluble vascular cell adhesion molecule-1 (sVCAM-1) and vascular endothelial growth factor (VEGF) in the observation group were lower than those in the control group (P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05).Conclusion Cyclosporine A combined with methylprednisolone has a prominent clinical effect on children with severe purpuric nephritis, can reduce the level of urine protein, and can effectively reduce the expression of VCAM-1 and VEGF.