《大剂量地塞米松与甲基强的松龙冲击治疗成人重症原发免疫性血小板减少症近期疗效比较》为作者：张正义最新的研究成果，本论文的主要观点为[摘要] 目的 比较大剂量地塞米松（dexamethasone，DEX）与甲基强的松龙（简称甲强龙，methylprednisolone，MTP）冲击治疗成人重症原发免疫性血小板减少症（primary immune thrombocytopenia，PITP）的近期临床疗效、不良事件发生率。方法 回顾性分析2008年7月至2015年12月我们两家医院收治的33例接受DEX和MTP治疗的成人重症PITP患者的临床资料。DEX组27例：静滴DEX 4Omg/天×4天单一疗程短周期治疗。MTP组6例：静滴1g/天×3天，之后继续口服强的松1mg/kg/天。采用单因素方差（one-way ANOVA）分析法比较两组患者治疗前及治疗后第7天患者的血小板数。χ2检验法比较2组患者完全反应率(complete response, CR)和反应率(response，R)、总反应率(overall response，OR)。检验水准为双边可信区间95%， P＜0。05为差异具有统计学意义。 结果 应用单因素方差分析（one-way ANOVA），治疗前DEX组与MTP血小板均数分别为（5。56±3。02）×109/L、（6。00±1。79）×109/L，治疗后第7天分别为（99。48±69。54）×109/L、（56。33±47。53）×109/L，比较治疗前与治疗后第7天各组血小板均数，各组间差异有统计学意义(F=29。11，P=0。000)。Levene检验方差不齐，进一步应用Dunnett’s T3法进行组间比较。治疗前组与甲强龙组血小板数差异无统计学意义（P=0。752）。治疗后第7天，DEX组血小板数上升，与治疗前相比差异有统计学意义(P=0。000)；MTP组血小板数上升，差异无统计学意义(P=0。200)。治疗后第7天DEX组与MTP组血小板数差异无统计学意义（P=0。405）。应用χ2检验，治疗后第7天DEX组CR率为44。4%，R率为48。1%，OR率92。5%，MTP组CR率为16。7%，R率为66。7%，OR率83。4%。因MTP组标本少，合并R+CR为OR，χ2检验比较2组OR率，差异无统计学意义（χ2=0。509，P=0。475）。DEX组不良事件发生率为40。7%(11/27)，MTP组不良事件发生率为83。8%（5/6），差异无统计学意义（χ2= 5。566，P=0。059）。 结论 大剂量DEX与MTP冲击治疗成人重症PITP患者，治疗后第7天血小板上升，DEX组差异有统计学有意义，而MTP组差异则无统计学意义。第7天DEX组CR率、OR率高于MTP，但差异无统计学意义。2组间不良事件发生率差异无统计学意义。 [Abstract] Objective Comparison the clinical short-term efficacy and adverse event rates of high-dose dexamethasone(DEX) and methylprednisolone(MTP) in the treatment of severe primary immune thrombocytopenia in adults。 Methods We had retrospectively analyzed 33 adult inpatients with PITP from July 2008 to December 2015。 All the adult patients had been divided into two groups: dexamethasone group(DEX group, n=27), methylprednisolone group (MTP group, n=6)。 Patients in DEX group had been infused Dex 40 mg per day for four consecutive days， and Patients in MTP group had been infused methylprednisolone 1000 mg per day for three consecutive days ,and then had taken orally prednisone 1mg/kg/d。 Then we had analyzed the platelet counts by one-way ANOVA before the treatment and on the seventh day after the treatment, and the rate of the complete response (CR), the response (R) and the overall response(CR plus R) by Chi square test。 A p-value less than 0。05 is considered statistically significant。 Results For statistical analysis by one-way ANOVA， patients in DEX and MTP groups the platelet counts on the seventh day after the treatment were significantly increased than that before treatment (F=29。11，P=0。000)。 Furthermore comparison by Dunnett’s T3 test between groups, the platelet counts after treatment significantly increased in the group DEX (p=0。000), and didn’t significantly increased in the group MTP (p=0。200)。 Between DEX and MTP groups, the platelet counts before treatment weren’t significantly different (p=0。752), and the platelet counts after treatment weren’t significantly different (p=0。405)。 For statistical analysis by Chi-square test，between DEX and MTP groups, the differences of the CR, R and OR weren’t statistically significant (χ2=0。509，P=0。475）, and the differences of the adverse event rates wasn’t statistically significant (χ2= 5。566，P=0。059）， too。 Conclusions The data show that high-dose dexamethasone and methylprednisolone have a well short-term efficacy, the platelet count significantly increased on the seventh day after treatment in group DEX， but didn’t increased on the seventh day after treatment in group MTP。 The OR rate of the adult patients with PITP in group DEX is higher than that in group MTP, but there isn’t significantly difference。 There isn’t significantly different adverse event rates between two groups。不知是否符合录用要求，望您批评与指正。