本研究旨在基于Meta分析评价血必净注射液联合CRRT治疗脓毒症所致急性肾损伤(Sepsis-associated acute kidney injury, SA-AKI)的临床疗效。在国内外数据库检索血必净注射液联合CRRT治疗SA-AKI的临床随机对照试验(randomized controlled trials, RCTs), 根据纳入和排除标准, 确定纳入的文献, 运用RevMan5.4软件对文献进行质量评估及Meta分析。共纳入20项试验, 1695例患者。结果显示, 与单纯CRRT治疗相比, 联合血必净注射液组的血清肌酐[SMD = –1.50, 95% CI (–1.89, –1.12)]、尿素氮[SMD = –1.61, 95% CI (–2.32, –0.90)]、血清胱抑素C [MD = –0.60, 95% CI (–1.05, –0.14)]; Acute Physiology And Chronic Health Evaluation Ⅱ评分(APACHE Ⅱ评分) [MD = –3.57, 95% CI (–4.73, –2.41)]、Sequential Organ Failure Assessment评分(SOFA评分)[MD = –2.46, 95% CI (–3.00, –1.92)]; 炎症指标: C反应蛋白(CRP) [SMD = –2.26, 95% CI (–2.82, –1.69)]、肿瘤坏死因子(TNF-α) [SMD = –2.45, 95% CI (–3.11, –1.79)]、白细胞介素-6 (IL-6) [SMD = –2.40, 95% CI (–3.01, –1.78)]; 免疫功能指标: CD3 [SMD = 2.79, 95% CI (1.41, 4.18)]、CD4 [SMD = 1.09, 95% CI (0.63, 1.55)]; 凝血功能指标: PT [SMD = –1.70, 95% CI (–2.46, –0.94), P < 0.0001]、APTT [SMD = –1.04, 95% CI (–1.25, –0.83), P < 0.00001]、Fib [SMD = 2.32, 95% CI (1.43, 3.21), P < 0.00001]; 死亡率[OR = 0.52, 95% CI (0.33, 0.83), P = 0.006] 均有统计学意义(P < 0.05)。脓毒症急性肾损伤在CRRT治疗的基础上联合血必净注射液治疗对肾功能的恢复、炎性因子的消除、免疫功能的改善、凝血功能的控制、死亡率的降低上明显优于单纯CRRT治疗。但由于试验整体质量不高, 仍需更多大样本、多中心、双盲的随机对照试验进一步支持。