目的 比较甲基强的松龙和地塞米松冲击治疗小儿急性原发免疫性血小板减少性紫癜的临床疗效及不良反应。方法 回顾性分析78例急性原发免疫性血小板减少性紫癜患儿，按给予冲击治疗的糖皮质激素不同分为甲基强的松龙冲击治疗组（n=44）和地塞米松冲击治疗组（n=34），两组患儿分别给予甲基强的松龙20～30 mg/(kg·d)，地塞米松1.5～2 mg/(kg·d)，均静滴3 d，第4天起减半，第7天改为口服阿赛松1.6 mg/(kg·d)序贯治疗。检测两组患儿血小板数目、计算达到完全有效或者有效的平均反应时间、自治疗开始至活动性出血停止的平均时间，观察治疗过程中两组患者不良反应发生情况。结果 患儿治疗有效率、治疗后活动性出血停止时间两组差异均无统计学意义（P＞0.05）。两组均未见严重不良反应，不良反应发生率差异无统计学意义（P＞0.05）。结论 两种糖皮质激素冲击治疗小儿急性原发免疫性血小板减少性紫癜均能收到较好疗效，短期不良反应轻微。

Objective To compare the clinical effect and adverse reactions of shock treatment with methylprednisolone and dexamethasone in children with acute primary idiopathic thrombocytopenic purpura (ITP). Methods We retrospectively reviewed a cohort of 78 children with acute primary ITP. The patients were divided into two groups, methylprednisolone group (n=44) and dexamethasone group (n=34). Patients in methylprednisolone group were given 20 — 30 mg/(kg·d) methylprednisolone for 3 d, and patients in dexamethasone group were given 1.5 — 2 mg/(kg·d) dexamethasone for 3 d. The amounts of drugs in two groups were reduced from the day 4. On the day 7, patients were po received Asaison 1.6 mg/(kg·d) to carry out sequential therapy. We observed the platelet counts and the responses to treatments in two groups, respectively. The platelet numbers of the two groups were detected and the average reaction time was calculated since the beginning of therapy to be completely effective or effective and bleeding stopped time. At the same time, the adverse reactions of the patients were observed during the treatment. Results There was no significant difference in the treatment efficiency and bleeding stopped time between two groups (P＞0.05). No patients experienced severe adverse reaction. There was no significant difference in the adverse reactions between two groups (P＞0.05). Conclusion Two kinds of glucocorticoid are equally effective in curing acute primary ITP, and the short-term adverse reactions are mild.