Objective To observe the clinical curative effect of tripterygium polyglycoside combined with cozaar in elderly patients with IgA nephropathy (IgAN) and its influence on expressions of TGF-β1,PAI-1 and VEGF.Methods Eighty elderly patients with IgA nephropathy in Jiaxing Hospital of Armed Police Zhejiang Corps from April 2011 to January 2016 were selected and randomly divided into the control group and observation group,40 cases in each group.The two groups received the routine treatment of chronic basic diseases and took oral cozaar.On this basis the observation group took tripterygium polyglycoside for continuous 12 months.Urine protein,serum creatinine (Scr),blood urea nitrogen (BUN),plasma Alb,urine TGF-β1,PAI-1 and VEGF levels before treatment and at 3,6,12 months after treatment were compared between the two groups.The occurrence situation of adverse reactions was recorded.Results The 24 h urinary protein levels at 3,6,12 months after treatment in the two groups were decreased,moreover the 24 h urine protein level at each time point in the observation group was lower than that in the control group,the difference was statistically significant (P<0.05).The levels of Scr,BUN,urine TGF-β1,PAI-1 and VEGF after treatment in the two groups were decreased compared with before treatment,while the Alb level was increased compared with before treatment,moreover the levels of Scr,BUN,urine TGF-β1,PAI-1 and VEGF in the observation group were lower than those in the control group,while the Alb level was higher than that in the control group,the difference was statistically significant (P<0.05).The observation group appeared 2 cases of leukopenia,1 case of liver dysfunction and no serious adverse reactions occurred.Conclusion Tripterygium polyglycoside combined with cozaar has a significant therapeutic effect on elderly patients with IgAN,can significantly reduce urinary protein and protect renal function,moreover its clinical use is safer.Its efficacy may be related to reducing the expression levels of TGF-β1,PAI-1 and VEGF.