Abstract: Objective To explore the clinical significance of platelet changes in thrombotic thrombocytopenic purpura (TTP)patients by treatment of anisodamine combined with plasma ex-change.Methods 78 patients with TTP were randomly divided into two groups,39 cases in each group.The research group was treated with anisodamine combined with plasma exchange,while the control group was treated only with plasma exchange.Changes of platelet counts before treatment and on days 2,5,12 and 21 after treatment as well as incidence of adverse reactions were observed in two groups.Clinical efficacy was compared.Results In the research group,healing rate was significantly higher and overall response rate was slightly higher than control group.On days 2,5, 12 and 21 after treatment,the platelet counts in both groups increased obviously.On days 2,5 and after treatment,the platelet count in research group was significantly greater than in control group. During treatment,no severe adverse reactions were observed in both groups.Conclusion Aniso-damine combined with plasma exchange can effectively accelerate the recovery of platelets in patients with TTP,reduce platelet consumption and microthrombosis and shows a significant efficacy and better safety.