Objective: To explore the effects of recombinant human brain natriuretic peptide combined with sodium nitroprusside and dopamine on patients with refractory heart failure and its effects on cardiac function. Methods: 90 patients with refractory heart failure were randomly divided into control group and observation group, with 45 cases in each group. The patients in 2 groups were all given conventional basic medication; On this basis, the patients in control group were given sodium nitroprusside and dopamine, the patients in observation group were given recombinant human brain natriuretic peptide, sodium nitroprusside and dopamine. The clinical efficacy, vital signs (blood pressure and heart rate), cardiac function and adverse drug reactions of patients in 2 groups were observed. Results: After treatment, the treatment effective rate of observation group was significantly higher than control group (55.56% vs 33.33%, P<0.05). There were no significant differences in the blood pressure, heart rate and incidence of adverse drug reactions between observation group and control group after treatment (P>0.05). The level of amino-terminal pro-brain natriuretic peptide (NT-proBNP) of patients in observation group was significantly lower than control group, while the left ventricular ejection fraction (LVEF) was significantly higher (P<0.05). Conclusions: Recombinant human brain natriuretic peptide combined with sodium nitroprusside and dopamine has significant treatment effects on patients with refractory heart failure, and it can effectively improve cardiac function. So it is worthy of clinical reference.