Abstract: Objective To investigate the application of continuous blood purification (CBP) and the effect of the angiotensin Ⅱ (Ang Ⅱ), aldosterone (ALD), atrial natriuretic peptide (ANP) in plasma with refractory heart failure(RHF) treated by CBP. Methods 35 eases with RHF were treated by CBP. Blood pressure, heart rate, respiration, blood oxygen saturation, blood markers of biochemistry, blood gas analysis, left ventricle ejection fraction (LVEF), cardiac function and AnglI, ALD, ANF in plasma were checked before and after treatment. Results The systolic pressure, diastolic pressure, heart rate, respiration, serum creatinine, blood urea nitroge, Ang Ⅱ, ALD, ANF in plasm after treatment were signifycanfly lower than those before treatment of CBP (P<0.05, P<0.01). The pH, HCO₃^-, PaO₂, LVEF after treatment were significantly higher than those before treatment of CBP (P<0.05, P<0.01). The edema of the patients was relieved, and the K⁺, Na⁺, Cl^- of blood serum were recovered normal after treatment, and cardiac function was recovered(P<0.05, P<0.01). Conclusion In the patients with RHF, CBP can efficiently treat the water-electrolyte disturbance, keep the acid-base balance, decrease the levels of AngⅡ, ALD, ANF in plasma, clear the inflammatory mediator and improve cardiac function.