Objective To detect the expression of microRNA-30a and microRNA-181a in peripheral blood mononuclear cells (PBMC) in patients with immune thrombocytopenic purpura (ITP) and to analyze their clinical significance.Methods A total of 48 patients with ITP admitted to our hospital from January 2020 to December 2020 were selected as ITP group, 40 patients with myelosuppression and thrombocytopenia after chemotherapy were selected as control group, and 45 healthy individuals undergoing physical examination were selected as health group. The platelet count (PLT) and mean platelet volume (MPV) of the three groups were tested. The expression levels of microRNA-30a and microRNA-181a in PBMC were detected by quantitative real-time polymerase chain reaction, and the correlation between the levels of microRNA-30a and microRNA-181a and the platelet parameters was analyzed. In addition, the diagnostic value of microRNA-30a and microRNA-181a for ITP was determined.Results The relative expression of microRNA-30a and microRNA-181a in the ITP group was higher than that of the control group and the health group (P < 0.05), while PLT and MPV in the ITP group were lower than those in the control group and the health group (P < 0.05). The relative expression of microRNA-30a was negatively correlated with PLT and MPV (r = -0.278 and -0.247, both P < 0.05), and positively correlated with bleeding grade (r = 0.221, P < 0.05). The relative expression of microRNA-181a was negatively correlated with PLT and MPV (r = -0.224 and -0.301, both P < 0.05), and positively correlated with bleeding grade (r = 0.236, P < 0.05). The increased relative expression of microRNA-30a [O^R = 1.876 (95% CI: 1.230, 6.336)] and that of microRNA-181a [O^R = 2.665 (95% CI: 1.365, 8.558)] were independent risk factors for ITP. The multiple regression equation of the prediction model based on the relative expression levels of microRNA-30a and microRNA-181a was established as Logistic (P) =-4.115 + 1.305 × MPV-1.258 × microRNA-30a -1.664×microRNA-181a. The standard error of the clinical model for diagnosing ITP was 0.055, the area under the receiver operating characteristic curve (AUC) was 0.889 (95% CI: 0.662, 0.956), the sensitivity was 75.25% (95% CI: 1.123, 2.084), and the specificity was 88.24% (95% CI: 1.672, 2.583).Conclusions The microRNA-30a and microRNA-181a are associated with the occurrence of ITP. The establishment of individualized prediction models based on microRNA-30a and microRNA-181a can accurately forecast the occurrence of ITP, and are of great value for clinical practice.