目的  本研究旨在探讨内毒素吸附(oXiris)血液滤过器在脓毒性休克相关急性肾损伤(acute kidney injury，AKI)患者中的疗效及预后。 方法  回顾性观察2024年1月—2025年6月兰州大学第二医院重症医学科65例脓毒性休克导致的AKI患者，分为oXiris组(32例)和ST150组(33例)。收集患者入院实验室检查和临床指标，比较2组连续性肾脏替代治疗(continuous renal replacement therapy，CRRT)前(0 h)、后(24 h)的循环参数、血管活性药物剂量、感染指标，通过Kaplan-Meier生存曲线分析14 d和28 d预后。 结果  ①与ST150组比较，oXiris组有更高的D-二聚体(Z=-2.605，P=0.009)、天门冬氨酸氨基转移酶(Z=-2.382，P=0.017)，更低的血小板(Z=-2.454，P=0.014)。②2组均肺部感染最多[7(21.9%)比13(39.4%)，χ2=2.314，P=0.126]，均以革兰氏阴性杆菌为主，主要是大肠埃希菌[8(25.0%)比8(24.2%)，χ2=0.005，P=0.943]。③与ST150组相比，oXiris组在治疗前(0 h)的去甲肾上腺素用量更高(Z=-2.565，P=0.010)；24 h后oXiris组的降钙素原(Z=-2.232，P=0.026)和白细胞介素-6(Z=-2.115，P=0.034)更低。④Kaplan-Meier生存曲线分析提示：2组的14 d和28 d累积生存率比较无统计学差异(χ2=0.275，P=0.600；χ2=0.099，P=0.753)。 结论  oXiris对于血管活性药物剂量需求较高的患者，在稳定血流动力和清除炎症因子方面具有明显优势，但并未改善患者短期及中期预后。

Objective  To investigate the efficacy and prognosis of the endotoxin-adsorbing (oXiris) hemofilter in patients with septic shock-associated acute kidney injury (AKI).  Methods  A retrospective observational study was conducted on 65 patients with AKI caused by septic shock in the Department of Critical Care Medicine, Lanzhou University Second Hospital, from January 2024 to June 2025. The patients were divided into an oXiris group (32 cases) and an ST150 group (33 cases). Laboratory tests and clinical indicators were collected upon admission. Circulatory parameters, vasoactive agent dosages, and infection markers were compared between the two groups before (0 h) and after (24 h) continuous renal replacement therapy (CRRT). Kaplan-Meier survival curves were used to analyze 14-day and 28-day outcomes.  Results  ①Compared with the ST150 group, the oXiris group had higher D-dimer (Z=-2.605, P = 0.009) and aspartate aminotransferase (Z = -2.382, P = 0.017), and lower platelet count (Z=-2.454, P =0.014). ② Pulmonary infection was common in both groups [7(21.9%) vs. 13(39.4%), χ²=2.314, P=0.126], and Gram-negative bacilli predominated, mainly Escherichia coli [8(25.0%) vs. 8(24.2%), χ²=0.005, P=0.943]. ③ Compared with the ST150 group, the oXiris group had a higher norepinephrine dosage before treatment (0 h) (Z=-2.565, P=0.010); after 24 h, the oXiris group had lower procalcitonin (Z=-2.232, P=0.026) and interleukin-6 levels (Z=-2.115, P=0.034). ④Kaplan-Meier survival curve analysis showed no statistically significant differences in 14-day and 28-day cumulative survival rates between two groups (χ²=0.275, P=0.600; χ²=0.099, P=0.753). Conclusion  oXiris has significant advantages in stabilizing hemodynamics and clearing inflammatory factors in patients with high vasoactive agent requirements, but it does not improve short-term or medium-term prognosis.