目的 分析碳青霉烯类抗生素联合血液滤过在脓毒性休克患者中的应用及对血清lncRNA XIST和miRNA-130a的影响。 方法 前瞻性选取2022年8月至2024年1月在医院治疗的脓毒性休克患者80例，随机分为对照组和观察组各40例，对照组使用碳青霉烯类抗生素，观察组使用碳青霉烯类抗生素与血液滤过联合治疗。观察两组的临床效果，比较两组血流动力学指标［包括心输出量（CO）、中心静脉压（CVP）、平均动脉压（MAP）］，免疫功能指标［包括白细胞介素（IL）-6、C反应蛋白（CRP）、肿瘤坏死因子（TNF）-α］，氧代谢指标［血氧饱和度（SaO₂）、血乳酸（LAC）、氧合指数（PaO₂/FiO₂）］以及血清lncRNA XIST和miRNA-130a表达水平。 结果 治疗后，两组CO、CVP、MAP、SaO₂、PaO₂/FiO₂水平与miRNA-130a表达均上升，而IL-6、CRP、TNF-α、LAC水平与lncRNA XIST表达下降，与治疗前相比差异有统计学意义（P < 0.05）。观察组CO、CVP、MAP水平与miRNA-130a表达高于对照组，而IL-6、CRP、TNF-α水平与lncRNA XIST表达低于对照组，差异有统计学意义（P < 0.05）。观察组的总有效率高于对照组（χ ² = 4.501，P < 0.05），两组不良反应发生情况无显著差异（χ ² = 0.180，P > 0.05）。 结论 碳青霉烯类抗生素与血液滤过治疗或通过下调lncRNA XIST表达，上调miRNA-130a表达，以及调节炎性因子，改善氧代谢指标，维持患者的血流动力学平衡进而改善脓毒性休克患者的症状。

Objective To evaluate the application of carbapenem antibiotics in conjunction with hemofiltration for patients with septic shock and to analyze the impact on serum levels of lncRNA XIST and miRNA-130a. Methods A prospective study was conducted on 80 patients with septic shock treated at our hospital from August 2022 to January 2024. These patients were randomly divided into a control group and an experimental group， each comprising 40 cases. The control group received carbapenem antibiotics， while the experimental group received carbapenem antibiotics in combination with hemofiltration. The clinical outcomes of both groups were evaluated， and comparisons were made regarding their hemodynamic indices ［including cardiac output （CO）， central venous pressure （CVP）， and mean arterial pressure （MAP）］， immune function indices ［including interleukin-6 （IL-6）， C-reactive protein （CRP）， and tumor necrosis factor-alpha （TNF-α）］， oxygen metabolism indices ［including blood oxygen saturation （SaO₂）， blood lactate （LAC）， and oxygenation index （PaO₂/FiO₂）］， as well as serum levels of lncRNA XIST and miRNA-130a expression. Results Following treatment， the levels of CO， CVP， MAP， SaO₂， PaO₂/FiO₂， and miRNA-130a were significantly increased， whereas the levels of IL-6， CRP， TNF-α， LAC， and lncRNA XIST were significantly decreased compared to pre-treatment levels （all P < 0.05）. In comparison with the control group， the experimental group exhibited significantly higher levels of CO， CVP， MAP， and miRNA-130a， as well as significantly lower levels of IL-6， CRP， TNF-α， and lncRNA XIST （all P < 0.05）. The overall effective rate in the experimental group was significantly higher than that in the control group （χ ² = 4.501， P < 0.05）， while no significant difference was observed in the incidence of adverse reactions between the two groups （χ ² = 0.180， P > 0.05）. Conclusion Carbapenem antibiotics and hemofiltration therapy can alleviate the symptoms of septic shock patients by downregulating lncRNA XIST expression， upregulating miRNA-130a expression， modulating inflammatory factors， enhancing oxygen metabolism indices， and maintaining hemodynamic stability.