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ObjectiveAntiplatelet therapy has been studied for its potential benefits in various cardiovascular conditions, but its role in sepsis remains less clear. This review aims to systematically analyse the available evidence on the effects of antiplatelet therapy in sepsis to assess its potential benefits and risks.Material and methodsThe studies published until 01st April 2024 from PubMed, Embase and Scopus databases were searched. Pooled effect sizes were reported as relative risks (RR) or weighted mean difference (WMD) with corresponding 95% confidence intervals (CI). Outcomes included mortality, length of intensive care unit (ICU) stay, hospital stay, and the risk of complications. The certainty of evidence was evaluated using GRADE.ResultsTwenty-one studies were included. Antiplatelet therapy was associated with significantly lower risk of in-hospital mortality (RR 0.76, 95% CI: 0.67, 0.87), and mortality at one (RR 0.77, 95% CI: 0.66, 0.90) and three months (RR 0.77, 95% CI: 0.66, 0.90) follow up. Risk of complications was comparable in all patients (RR 1.01, 95% CI: 0.84, 1.21). ICU stay (in days) (WMD -0.23, 95% CI: -0.53, 0.07; N=7, I2=97.2%) and overall duration of hospital stay (in days) (WMD 0.63, 95% CI: -0.66, 1.92; N=6, I2=93.2%) was also statistically similar among patients who received and did not receive antiplatelet drugs. The certainty of evidence for the outcomes ranged from “low to very low”.ConclusionAntiplatelet therapy appears safe and significantly lowers the risk of short-term mortality in septic patients. While antiplatelet therapy did not impact the duration of ICU or overall hospital stay, our findings underscore the potential of antiplatelet agents as a beneficial adjunctive therapy in sepsis management.Objective 抗血小板治疗在多种心血管疾病中的潜在获益已得到广泛研究，但其在脓毒症中的作用仍不甚明确。本综述旨在系统分析现有关于抗血小板治疗用于脓毒症的疗效证据，以评估其潜在获益与风险。 Material and methods 研究方法：检索截至2024年4月1日PubMed、Embase及Scopus数据库中已发表的相关研究。合并效应量以相对危险度（RR）或加权均数差（WMD）及对应95%置信区间（CI）报告。结局指标包括病死率、重症监护病房（ICU）住院时长、总住院时长及并发症发生风险。采用GRADE分级系统评估证据确定性。 Results 结果：共纳入21项研究。抗血小板治疗与院内病死率（RR=0.76，95%CI：0.67~0.87）、随访1个月（RR=0.77，95%CI：0.66~0.90）及3个月（RR=0.77，95%CI：0.66~0.90）病死率显著降低相关。所有患者的并发症发生风险无显著差异（RR=1.01，95%CI：0.84~1.21）。接受与未接受抗血小板药物的患者，其ICU住院时长（天）（WMD=-0.23，95%CI：-0.53~0.07；N=7，I²=97.2%）及总住院时长（天）（WMD=0.63，95%CI：-0.66~1.92；N=6，I²=93.2%）均无统计学差异。各结局指标的证据确定性为“低至极低”。 Conclusion 结论：抗血小板治疗安全性良好，可显著降低脓毒症患者的短期病死率。尽管抗血小板治疗对ICU住院时长及总住院时长无显著影响，但本研究结果凸显了抗血小板药物作为脓毒症管理中潜在有益辅助治疗手段的价值。