目的:评价糖皮质激素联合重组人促血小板生成素(rhTPO)治疗重症原发免疫性血小板减少症(ITP)的疗效和安全性。方法:收集符合诊断标准的重症ITP患者39例,其中采用rhTPO治疗21例作为研究组(rhTPO组),采用丙种球蛋白治疗18例作为对照组(丙球组)。采用独立样本的非参数检验比较2组的临床疗效。结果:1rhTPO组和丙球组治疗有效率分别为95.2%和100%,2组间差异无统计学意义(P>0.05);2rhTPO组和丙球组血小板开始恢复时间分别为(4.44±0.88)d和(5.52±2.65)d,2组间差异无统计学意义(P>0.05);3治疗7d后,rhTPO组和丙球组血小板计数分别为(81.8±29.1)×109/L和(130.0±56.5)×109/L;而治疗14d后,血小板计数分别为(238.3±95.3)×109/L和(221.4±83.3)×109/L,2组间比较均差异无统计学意义(P>0.05)。结论:rhTPO联合地塞米松与丙种球蛋白联合地塞米松治疗重症ITP疗效相当,可作为重症ITP的一线治疗方法。 Objective: To evaluate the efficacy and safety of glucocorticoid combined with recombinant human thrombopoietin (rhTPO) in the treatment of severe idiopathic thrombocytopenia (ITP). Methods: Thirty-nine patients with severe ITP were enrolled in the study. Among them, 21 patients were treated with rhTPO (rhTPO group) and 18 patients were treated with gamma globulin (control group). Nonparametric tests with independent samples were used to compare the clinical efficacy of the two groups. Results: The effective rates of treatment with 1rhTPO and corticosteroids were 95.2% and 100% respectively, with no significant difference between the two groups (P> 0.05). The recovery time of platelets in the two rhTPO group and the control group was (4.44 ± 0.88) d and (5.52 ± 2.65) d, respectively. There was no significant difference between the two groups (P> 0.05) .3 After 7 days of treatment, the platelet counts of rhTPO group and group B were (81.8 ± 29.1) × 109 / L and ± 56.5) × 109 / L, respectively. After 14 days of treatment, the platelet counts were (238.3 ± 95.3) × 109 / L and (221.4 ± 83.3) × 109 / L, respectively. There was no significant difference between the two groups (P> 0.05). Conclusion: rhTPO plus dexamethasone and gamma globulin combined with dexamethasone in treatment of severe ITP have similar efficacy and can be used as first-line treatment for severe ITP.