Abstract: Objective To observe the clinical effect of tolvaptan tablets in the treatment of refractory heart failure. Methods 52 patients with refractory chronic heart failure were randomly divided into observation group and control group. The control group was treated with conventional anti-heart failure therapy，and the observation group was given tolvaptan tablets orally on the basis of the treatment of the control group，and the improvement effect of heart failure in the two groups was compared. Results After one week of continuous treatment，compared with the control group，the symptoms and signs of heart failure in the observation group，such as dyspnea，pulmonary congestion and lower limb edema were significantly improved；the serum NT-proBNP decreased，the left ventricular ejection fraction increased，and the serum sodium ion concentration increased，the degrees were all better than those of the control group（P < 0. 05）；meanwhile，there was no significant increase in blood creatinine level（P > 0. 05）. Conclusion On the basis of conventional anti-heart failure treatment，oral tolvaptan tablets has a good clinical effect on refractory heart failure and has no obvious effect on renal function.

Key words: refractory heart failure, tolvaptan；NT- proBNP, left ventricular ejection fraction, serum sodium ion concentration