在血友病患者,免疫性血小板减少性紫癜(ITP)可能成为人类免疫缺陷病毒(HIV)感染的致命性并发症。作者报告4例有HIV相关ITP的重症血友病患者脾切除术的治疗效果。4例均为血友病甲,因子Ⅷ水平低于1%,测不出抑制因子滴度,在确诊ITP时HIV—Ⅰ感染的血清反应阳性。ITP起病时,他们的年龄为11～30岁,在外科治疗前,4例患者有至少持续6个月的血小板减少, In patients with hemophilia, immune thrombocytopenic purpura (ITP) may be a fatal complication of human immunodeficiency virus (HIV) infection. The authors report the efficacy of splenectomy in 4 patients with severe hemophilia who have HIV-associated ITP. 4 cases were hemophilia A, factor Ⅷ level less than 1%, can not measure the inhibitory factor titer, HIV-I infection in the diagnosis of ITP seropositive. At the onset of ITP, their age ranged from 11 to 30 years. Before surgery, 4 patients had thrombocytopenia lasting at least 6 months,