Objective To investigate the characteristics of clopidogrel-associated thrombocytopenia to provide references for clinically safe drug use.Methods The case reports of thrombocytopenia induced by clopidogrel published in PubMed,Embase,CNKI,Wanfang and VIP were searched from the establishment of each database to November 2022,and their occurrence was collated and analysed.Results A total of 44 cases from 43 articles were identified and included in the analysis.There were 30 males(68.2％)and 14 females(31.8％).Ages ranged from 37 to 88(65.0±11.4)years,of which 30(68.2％)were ≥60 years old.Thrombocytopenia was found from 8 h to 9 months after medication,of which 29 cases(65.9％)appeared within two weeks.There were 31 cases(70.5％)with severe thrombocytopenia and 38 cases(86.4％)with complications,of which 24 cases(63.2％)with bleeding and 19 cases(50.0％)with thrombotic thrombocytopenic purpura(TTP).The platelet countof41 cases(93.2％)returned to normal after drug withdrawal and symptomatic treatment,and 3 cases(6.8％)died finally.Conclusion Clopidogrel related thrombocytopenia is mainly severe thrombocytopenia,and often accompanied by bleeding or thrombotic thrombocytopenic purpura(TTP),but the overall outcome is good.Platelet count should be regularly monitored within the first two weeks after medication.Clopidogrel should be stopped and symptomatic treatment should be given in case of any abnormality.

Objectives:To investigate the risk factors of sarcopenia in patients receiving maintenance peritoneal dialysis (MPD).Methods:One hundred and thirteen patients receiving maintenance MPD for ≥3 months during January and December 2017 were enrolled in this study. According to the Asian Working Group for Sarcopenia(AWGS)algorithm, there were 26 patients with sarcopenia accounting for 23.0% of all MPD patients. Demographic and anthropometric data were collected; laboratory tests were conducted, Kt/V urea and normalized protein equivalent of total nitrogen appearance were calculated; the bioelectrical impedance analysis (BIA) was performed and grip strength was tested. The nutritional status was evaluated with Subjective Global Assessment (SGA). Logistic regression was used to analyze the risk factors of sarcopenia in MPD patients. Results:BMI and dialysis dose of patients with sarcopenia were significantly lower than those without sarcopenia [(20.35±2.35) kg/m 2vs. (23.81±3.14) kg/m 2, t=-5.181, P<0.01; (5.57±1.83) L/d vs. (6.66±1.71) L/d, t=-2.795, P<0.01]. The bioelectrical impedance analysis showed that the total water content of patients with sarcopenia was higher than that of patients without sarcopenia [(35.44±6.40) kg vs. (28.52±4.89) kg, t=5.077, P<0.01]; while the protein content[(7.46±1.31) kg vs. (9.24±1.63) kg, t=-5.080, P<0.01] and skeletal muscle content [(20.54±4.18) kg vs. (25.88±4.95) kg, t=-4.980, P<0.01] of patients with sarcopenia were lower than those without sarcopenia. Multivariate analysis showed that decreased BMI( OR=0.934, 95 %CI: 0.723-0.998, P<0.01) and body protein ( OR=0.927, 95 %CI: 0.698-0.996, P<0.01), increased total body water( OR=1.382, 95 %CI: 1.053-1.813, P=0.02) were independent risk factors for sarcopenia in MPD patients. Conclusion:The incidence of sarcopenia in MPD patients is high, which is associated with the excessive volume load and malnutrition of patients.