小剂量氨氯地平对射血分数下降心力衰竭患者肾功能影响的初步研究

Preliminary study on the effect of low-dose amlodipine on renal function in patients with heart failure with reduced ejection fraction

目的探讨小剂量氨氯地平对射血分数下降心力衰竭(心衰)患者肾功能的影响。方法选取2021年6月至2022年6月因心衰发作于聊城市第二人民医院心内科住院且符合射血分数下降心衰的患者120例,随机分为实验组和对照组,对照组给予常规治疗,实验组在常规治疗基础上加用小剂量氨氯地平。记录两组脑钠肽(BNP)、左心室内径、射血分数、肾小球滤过率,4周后复查。结果4周后两组患者的BNP下降幅度有统计学差异(P<0.05),两组左心室内径、射血分数的前后改变均无统计学意义(P>0.05)。实验组的肾小球滤过率水平较4周前有明显改善(P<0.05),而对照组的变化无统计学差异(P>0.05)。同时,在实验组中未观察到明显的低血压、外周水肿及心律失常等不良反应。结论小剂量氨氯地平短期内改善射血分数下降心衰患者的肾小球滤过能力,阻止肾功能下降,提示小剂量氨氯地平也许是射血分数下降心衰患者治疗的有益补充。

Objective To investigate the effect of low-dose amlodipine on renal function in patients with heart failure and decreased ejection fraction.Methods A total of 120 patients with heart failure and decreased ejection fraction who were admitted to the Cardiology Department of the Second People's Hospital of Liaocheng City due to heart failure from June 2021 to June 2022 were randomly divided into an experimental group and a control group.The control group received routine treatment,while the experimental group received low-dose amlodipine in addition to routine treatment.B-type natriuretic peptide(BNP),left ventricular internal diameter,ejection fraction,and glomerular filtration rate were recorded in both groups and rechecked after 4 weeks.Results After 4 weeks,there was a statistically significant difference in the decrease of BNP between the two groups(P<0.05),while there was no statistically significant difference in the changes of left ventricular internal diameter and ejection fraction between the two groups(P>0.05).The level of glomerular filtration rate in the experimental group was significantly improved compared with that before 4 weeks(P<0.05),while there was no statistically significant difference in the control group(P>0.05).At the same time,no obvious adverse reactions such as hypotension,peripheral edema,or arrhythmia were observed in the experimental group.Conclusion Low-dose amlodipine can improve the glomerular filtration capacity of patients with heart failure and decreased ejection fraction in a short time,and prevent the decline of renal function,suggesting that low-dose amlodipine may be a beneficial supplement for the treatment of patients with heart failure and decreased ejection fraction.