目的 探究小剂量多巴胺联合重组人脑利钠肽（rhBNP）对射血分数降低心力衰竭（HFrEF）肾血流阻力指数（RRI）及利尿效果的作用。方法 选择2022年10月-2025年9月104例于本院诊治的HFrEF患者，随机对照法分为两组，在接受心力衰竭常规治疗基础上，对照组接受rhBNP治疗，观察组接受小剂量多巴胺联合rhBNP治疗。比较两组RRI、利尿效果、心肾功能指标及不良反应。结果 两组治疗前血肌酐（SCr）、尿素氮（BUN）、估算肾小球滤过率（eGFR）及RRI均无统计学差异（P>0.05），治疗后两组SCr、BUN、RRI下降、而eGFR上升（P<0.05），且与对照组相比，观察组SCr、BUN、RRI更低、eGFR更高（P<0.05）。治疗期间观察组24 h尿量多于对照组，治疗前后观察组体质量下降幅度高于对照组（P<0.05）。两组治疗前左心室射血分数（LVEF）、N末端前脑钠肽（NT-proBNP）无统计学差异（P>0.05），治疗后两组LVEF升高、NT-proBNP降低（P<0.05），且与对照组相比，观察组LVEF更高、NT-proBNP更低（P<0.05）。对照组（3/52）与观察组（5/52）不良反应比较，差异无统计学意义（χ2=0.135，P>0.05）。结论 小剂量多巴胺联合rhBNP治疗HFrEF患者可降低肾血流阻力指数，改善肾脏血流灌注与心肾功能，加强利尿效果，且具有良好安全性。
Objective To investigate the effects of low-dose dopamine combined with recombinant human brain natriuretic peptide (rhBNP) on renal blood flow resistance index (RRI) and diuretic efficacy in patients with heart failure with reduced ejection fraction (HFrEF). Methods From October 2022 to September 2025, 104 HFrEF patients treated at our hospital were randomly divided into two groups. Both groups received standard heart failure therapy; the control group received rhBNP alone, while the study group received low-dose dopamine combined with rhBNP. The RRI, diuretic effect, cardiac and renal function indicators, and adverse reactions were compared between the two groups. Results Before treatment, serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), and RRI showed no significant differences between the two groups (P > 0.05). After treatment, both groups exhibited decreased SCr, BUN, and RRI, along with increased eGFR (P < 0.05). Compared with the control group, the study group had significantly lower SCr, BUN, and RRI, and higher eGFR (P < 0.05). During treatment, the study group had greater 24-hour urine output than the control group, and the reduction in body weight was more pronounced in the study group before and after treatment (P < 0.05). There were no significant differences in left ventricular ejection fraction (LVEF) and N-terminal pro-brain natriuretic peptide (NT-proBNP) between the two groups before treatment (P > 0.05). After treatment, both groups showed improved LVEF and reduced NT-proBNP levels (P < 0.05), and the study group demonstrated higher LVEF and lower NT-proBNP compared to the control group (P < 0.05). Adverse reactions occurred in 3 out of 52 patients in the control group and 5 out of 52 in the study group, showing no statistically significant difference (χ2 = 0.135, P > 0.05). Conclusion Low-dose dopamine combined with rhBNP can reduce the renal blood flow resistance index, improve renal perfusion and cardiorenal function, enhance diuresis, and is safe and well-tolerated.
