【摘要】目的探讨益生菌、益生元和合生元降低维持性血液透析患者尿毒症毒素及改善微炎症状态的效果。方法计算机检索中国知网、中国生物医学文摘数据库、万方、维普及PubMed、Embase、Cochrane library、Web of Science 建库至2019 年2 月关于维持性血液透析患者使用微生物制剂(包括益生菌、益生元、合生元)的相关文献，根据纳排标准进行筛选，采用RevMan5.3 进行Meta 分析。结果共纳入文献10篇，患者共计481 例。Meta分析显示，微生物制剂组患者硫酸对甲酚较对照组下降[MD (95% CI)，P为 -0.71 (-1.37，-0.06），0.030]，差异有统计学意义。在硫酸吲哚酚、C-反应蛋白、尿素及肌酐上无统计学差异，MD (95% CI)，P 分别为[-0.38,(-0.98，0.22),0.220]，[-1.49,(-8.00,5.01)，0.650], [1.48,(-3.79，6.75),0.580]和[-0.15,(-1.21，0.92),0.790]。结论微生物制剂对降低维持性血液透析患者蛋白结合类毒素有一定疗效，但真正应用于临床仍需要大样本多中心的随机对照研究及更严谨的研究设计支持。

【Abstract】Objective To explore the effects of microbiological preparations on inflammation and uremic toxins among hemodialysis patients. Methods We searched CNKI, CBM, WanFang Data, VIP, PubMed, Embase, Cochrane library, Web of Science, from inception to February 2019 to collect the related literature. RevMan 5.3 software was used for meta-analysis. Results A total of 10 articles involving 481 cases were included. Meta-analysis showed that the reduction of P-cresyl sulfate (PCS) was different between microbial preparations group and placebo group, with the mean differences (MDs) of -0.71 (95% CI -1.37~-0.06, P= 0.030). There were no significant changes in indoxyl sulfate (IS), CRP, urea and creatinine between the two groups, withMDs of -0.38 (95% CI -0.98~ 0.22, P=0.220) for IS,MDs of -1.49 (95% CI-8.00~5.01, P=0.650) for CRP, MDs of 1.48 (95% CI - 3.79~ 6.75, P=0.580) for urea, and MDs of - 0.15 (95% CI - 1.21~0.92, P=0.790) for creatinine. Conclusion Prebiotics, probiotics and synbiotics may have an effect on hemodialysis patients. However, more rigorous design, large scale, multi-center and randomized controlled clinical trials are needed to verify the study.