Inclusion Criteria:  clinically diagnosed as TTP (thrombocytopenia + MAHA± clinical evidence of related organ damage， a significant reduction in ADAMTS13 activity level and/or positive antibody screening） elder than 18 years old; informed consent is required;  Exclusion Criteria:  Uncontrollable systemic infection; Known allergy to bortezomib; Expected survival time <1 week; Pregnant or lactating women (women of childbearing age have a positive pregnancy test at baseline or have not received a pregnancy test. Postmenopausal women must be at least 12 months after menopause); If the creatinine level is ≥200μmol/l (1.5mg/dl), the levels of transaminase and bilirubin are 2 times higher than the upper limit of normal (except due to the primary disease); Known congenital TTP or a clear family history of TTP; Other diseases that cause microangiopathic hemolysis and thrombocytopenia, such as DIC, APS, HUS, malignant hypertension, transplantation-related microangiopathy; active malignant tumors (except skin basal cell carcinoma or cervical carcinoma in situ) ( have not been treated or recurred within 5 years before signing the informed consent); peripheral neuropathy; Patients or family members cannot understand the conditions and goals of this study; The investigator believes that the patient should not participate in any other situations in this trial.