目的 觀察地塞米松聯(lián)合重組人血小板生成素治療免疫性血小板減少癥（ITP）的療效。方法 選擇2009年02月—2012年11月鄭州人民醫(yī)院收治的ITP患者36例，隨機(jī)分為治療組和對(duì)照組，每組18例。治療組靜脈滴注地塞米松治療15 mg/d，連續(xù)7 d，治療無效，繼續(xù)應(yīng)用地塞米松15 mg/d最長(zhǎng)至28 d，第8天加用重組人血小板生成素1.5×104 U，皮下注射，1 次/d，根據(jù)血小板恢復(fù)情況用7～14 d。對(duì)照組應(yīng)用地塞米松用法及用量同治療組，最長(zhǎng)治療28 d。治療結(jié)束后，計(jì)算兩組達(dá)到血小板良效的平均時(shí)間和總有效率，同時(shí)觀察不良反應(yīng)發(fā)生情況。結(jié)果 治療組達(dá)到血小板良效的平均時(shí)間為（17.88±3.67）d，對(duì)照組為（21.63±5.75）d，兩組差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）；治療組總有效率為88.89%，對(duì)照組為77.78%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。兩組均可發(fā)生頭暈、消化道出血、肝功能異常、骨質(zhì)疏松、血糖升高、高血壓、惡心、嘔吐、納差等不良反應(yīng)，治療組發(fā)生率為22.22%，對(duì)照組為27.78%，兩組比較差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 糖皮質(zhì)激素聯(lián)合重組人血小板生成素治療ITP優(yōu)于糖皮質(zhì)激素單藥治療，且不良反應(yīng)較少，可選擇應(yīng)用。

Objective To observe the clinical effect of dexamethasone (Dex) combined with recombinant human thrombopoietin in the treatment of immune thrombocytopenia (ITP). Methods ITP patients (36 cases) in People’s Hospital of Zhengzhou from February 2009 to November 2012 were randomly divided into the treatment (18 cases) and control (18 cases) groups. Patients in the treatment group were iv administered with Dex 15 mg/d for 7 d. While the treatment was invalid, and Dex administration was continued up to 28 d. On the day 8, patients in the treatment group were sc injected with human thrombopoietin 1.5×104 U, once daily, for 7—14 d according to platelet recovery. The usage of Dex in the control group was the same as the treatment group for 28 d. Mean time to reach the good effect of platelet and total efficiency was calculated at the end of the treatment. At the same time, adverse reaction was observed in the treatment. Results Mean time to reach the good effect of platelet in the treatment and control groups was (17.88 ± 3.67) and (21.63 ± 5.75) d with significant difference (P < 0.05), and the efficiencies in the treatment and control groups were 88.89% and 77.78% with significant difference (P < 0.05). Patients in the two groups had dizziness, gastrointestinal hemorrhage, hepatic dysfunction, osteoporosis, hyperglycemia, hypertension, nausea, vomiting, anorexia, and other adverse reactions, and the incidence rates were 22.22% and 27.78% in the treatment and control groups with no significant difference. Conclusion Dex combined with human thrombopoietin in the treatment of ITP with few adverse reaction is better than Dex alone, which is suitable for usage.