目的 分析美羅培南致血小板計(jì)數(shù)異常（增多或減少）的發(fā)生特點(diǎn)，為臨床合理用藥提供參考。方法 檢索PubMed、Embase、MedLine、Research Gate、中國知網(wǎng)、萬方數(shù)據(jù)庫和維普數(shù)據(jù)庫，時(shí)間截止至2022年5月，納入美羅培南致血小板計(jì)數(shù)異常的中英文病例報(bào)道，對(duì)文獻(xiàn)進(jìn)行篩選、數(shù)據(jù)歸納及統(tǒng)計(jì)。結(jié)果 最終納入22例患者，其中男性13例，女性9例；年齡0.5～96歲，平均（59.98±25.34）歲；14例患者患有基礎(chǔ)疾病，15例患者為聯(lián)合用藥。引起血小板計(jì)數(shù)增多癥患者9例（40.91%），血小板計(jì)數(shù)減少癥患者13例（59.09%），所有患者血小板計(jì)數(shù)異常均發(fā)生在用藥期間。停用美羅培南并給予對(duì)癥處理后，21例（95.45%）患者血小板計(jì)數(shù)恢復(fù)正?；蚝棉D(zhuǎn)。結(jié)論 美羅培南致血小板計(jì)數(shù)異常以血小板減少癥相對(duì)多見。臨床在使用美羅培南期間應(yīng)加強(qiáng)對(duì)血小板計(jì)數(shù)的監(jiān)測(cè)，一旦發(fā)現(xiàn)異常變化應(yīng)及時(shí)停藥和對(duì)癥處理，減少血栓或出血事件的發(fā)生。

Objective To analyze the characteristics of abnormal platelet count (increase or decrease) caused by meropenem, and to provide references for rational drug use in clinic. Methods The Pubmed, Embase, Medline, Research Gate, CNKI, Wanfang, and VIP database were searched until May 2022. Both Chinese and English case reports of platelet count abnormalities caused by meropenem were included, and the data were extracted and analyzed. Results 22 Patients were included, including 13 males and 9 females. The age ranged from 0.5 to 96 years, and the overall mean age was (59.98 ±25.34) years. 14 patients suffered from basic diseases, and 15 patients were treated with combination therapy. 9 Patients (40.91%) with thrombocytopenia and 13 patients (59.09%) with thrombocytopenia, all patients had abnormal platelet count during medication. After discontinuation of meropenem and symptomatic treatment, platelet count returned to normal or improved in 21 patients (95.45%). Conclusion Thrombocytopenia is more common than thrombocythemia. During the clinical use of meropenem, the monitoring of platelet count should be strengthened. Once abnormal changes are found, the drug should be stopped in time and symptomatic treatment should be given to reduce the occurrence of thrombosis or bleeding events.

R978.1