目的 观察地塞米松联合重组人血小板生成素治疗免疫性血小板减少症（ITP）的疗效。方法 选择2009年02月—2012年11月郑州人民医院收治的ITP患者36例，随机分为治疗组和对照组，每组18例。治疗组静脉滴注地塞米松治疗15 mg/d，连续7 d，治疗无效，继续应用地塞米松15 mg/d最长至28 d，第8天加用重组人血小板生成素1.5×104 U，皮下注射，1 次/d，根据血小板恢复情况用7～14 d。对照组应用地塞米松用法及用量同治疗组，最长治疗28 d。治疗结束后，计算两组达到血小板良效的平均时间和总有效率，同时观察不良反应发生情况。结果 治疗组达到血小板良效的平均时间为（17.88±3.67）d，对照组为（21.63±5.75）d，两组差异有统计学意义（P＜0.05）；治疗组总有效率为88.89%，对照组为77.78%，两组比较差异有统计学意义（P＜0.05）。两组均可发生头晕、消化道出血、肝功能异常、骨质疏松、血糖升高、高血压、恶心、呕吐、纳差等不良反应，治疗组发生率为22.22%，对照组为27.78%，两组比较差异无统计学意义。结论 糖皮质激素联合重组人血小板生成素治疗ITP优于糖皮质激素单药治疗，且不良反应较少，可选择应用。

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.