Objective To observe the effect and side effect of Levosimendan for treatment of Refractory heart failure. Method There were 30 heart failure patients who got poor effects by conventional heart failure therapy. Everyone was given the levosimendan continuous intrave-nous drip(0. 1 to 0. 2 ug/kg/min,according to the directions ),to observe the effects and side effects. Results 30 patients used levosimendan total 54 times and 41 times were effective,Some patients continuously repeatedly used. The effective rate was 75. 9%. The average last time of levosimendan was(26. 4 ± 3. 6)hours. The average time from starting to relief of shortness was(30 ± 4. 8)hours,the NT - proBNP had ob-vious difference before and after using levosimendan(6 727. 4 ± 2 086. 59 VS 3 806. 4 ± 2 945. 5,P﹤0. 05). Excluded renal failure patients, the creatinine levels reduced after using levosimendan(105. 7 ± 26. 3 VS 91. 2 ± 18. 7,P﹤0. 05)). Conclusion Small doses of levosimen-dan through continuously intravenous drip to treat acute refractory heart failure caused by different causes showes a great effect and less ad-verse reaction;But the effect is poor for patients with renal failure and( or)ischemic cardiomyopathy without vascular interventional treatment;Frequent ventricular premature beat and low blood pressure are not the contraindications of levosimendan if using anti-arrhythmic drugs and booster drugs at the same time.%目的：观察左西孟旦（ Levosimendan）小剂量静脉维持治疗各种原因引起的30例顽固性急性心力衰竭患者的效果及不良反应。方法：30例心力衰竭患者，均为使用常规抗心力衰竭治疗效果欠佳者，给予左西孟旦小剂量持续静脉滴注（0.1~0.2μg/kg/min，根据说明书），观察使用左西孟旦过程中出现的不良反应及治疗效果。结果：30例患者共54次使用左西孟旦，部分患者间断重复使用。其中有效次数41次，有效率75.9％。使用左西孟旦平均维持时间（26.4±3.6）h。观察患者开始使用药物到气短症状开始缓解平均时间为（30±4.8）h，使用左西孟旦前后NT-proBNP有明显差异（6727.4±2086.59 VS 3806.4±2945.5，P﹤0.05），两组比较，差异均有统计学意义（P﹤0.05）。排除肾功能不全患者，使用左西孟旦后肌酐水平较前下降（105.7±26.3VS 91.2±18.7，P﹤0.05），两组比较，差异均有统计学意义。结论：小剂量左西孟旦持续静脉推注维持治疗各种病因引起急性顽固性心力衰竭效果佳，不良反应少；但对于肾功能不全患者及缺血性心肌病未行介入治疗开通血管患者治疗效果差；频发室性早搏及血压偏低并非使用左西孟旦禁忌证，可同时使用抗心律失常及升压药物。
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