Abstract: ［Abstract］〓Objective〖HTSS〗〓To observe the clinical efficacy of triple combination of sodium nitroprusside, dopamine and rhBNP in the treatment of refractory heart failure.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 120 patients with refractory heart failure who were admitted in our hospital were included in the study and randomized into groups A, B, C, and D with 30 cases in each group. The patients in the four groups were given routine antiheart failure treatments. On the above basis, the patients in group A were given sodium nitroprusside+dopamine, those in group B were given rhBNP+sodium nitroprusside, those in group C were given rhBNP+dopamine, and those in group D were given sodium nitroprusside+dopamine+rhBNP. After 7day treatment, the clinical symptoms, signs remission, and the first 24 h urine volume after treatment in the four groups were observed. The serum BNP and cardiac ultrasound improvement were compared.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The comparison of the clinical efficacy and the total effective rate 7 d after treatment among the four groups was not significantly different(P＞005). BNP levels after treatment in the four groups were significantly reduced when compared with before treatment(P＜005). BNP levels in groups B, C, and D were significantly lower than those in group A(P＜005). The reduced degree of BNP level in groups B and C was significantly greater than that in group A(P＜005) . The reduced degree of BNP level in group C was significantly less than that in group B(P＜005). And the reduced degree of BNP level in group D was significantly greater than that in groups A, B, and C(P＜005). The first 24 h urine volume after treatment in the four groups was significantly increased when compared with before treatment(P＜005). The first 24 h urine volume in group D was significantly higher than that in groups A, B, and C(P＜005). The increased degree of the first 24 h urine volume in groups B, C, and D was significantly greater than that in group A(P＜005). The increased degree of the first 24 h urine volume in group D was significantly greater than that in groups B and C(P＜005). Left ventricular ejection fraction（LVEF） value after treatment in the four groups was not significantly different when compared with before treatment(P＞005). Left ventricular enddiastolic diameter（LVEDd） after treatment was significantly reduced when compared with before treatment(P＜005). The comparison of LVEF and LVEDd among the four groups was not statistically significant(P＞005). In group B, 2 cases had hypotension, and no adverse reactions occurred in other 3 groups.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The triple combination of sodium nitroprusside, dopamine and rhBNP in the treatment of refractory heart failure can significantly improve the clinical symptoms and diuretic resistance, reduce BNP level, and contribute to the rehabilitation.

Key words: heart failure, nitroprusside, dopamine, rhBNP