OBJECTIVE： To investigate the effects， prognosis and safery of recombinant human brain natriuretic peptide on the treatment of patients with acute decompensated heart failure. METHODS： 90 inpatients with acute decompensated heart failure were divided into observation group and control group according to the use of recombinant human brain natriuretic peptide or not， with 45 cases in each group. Control group received rountine anti-heart failure therapy and intravenous dripping of Nitroglycerin injection at 20 μg/min continuously for 72 h. Observation group was additionally given Lyohilized recombinant human brain natriuretic peptide with initial loading amount of 1.5 μg/kg， iv， then intravenous dropping at 0.007 5 μg/（kg·min） continuously for 72 h， on the basis of control group. Hemodynamic parameters， brain natriuretic peptide level， the difference of liquid intake and output， dyspnea， lung rales， systemic edema， the improvement of cardiac function were observed and compared between 2 groups before and after treatment as well as re-hospitalization rate and surriral rate 30 d after medication， the occarrence of ADR. RESULTS： After treatment， left ventricular ejection fraction of observation group was significantly higher than that of control group， and central venous pressure and brain natriuretic peptide level were lower than those of control group， with statistically significance （P＜0.05）. The difference of liquid intake and output after treatment was （1 171.60±444.80）ml in observation group and （822.30±268.40）ml in control group， with statistical significance between 2 groups （P＜0.05）. After treatment， the scores of dyspnea， lung rales and systemic edema were decreased in 2 groups； the improvement of observation group was significantly better than that of control group， with statistical significance （P＜0.05）. Total effective rates of observation group and control group were 95.56％ and 82.22％； re-hospitalization rates 30 d after medication were 17.78％ and 26.67％； survival rates 30 d after medication were 88.89％ and 75.56％， with statistical significance between 2 groups （P＜0.05）. There was no statistical significanse in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Recombinant human brain natriuretic peptide can significantly improve hemodynamic parameters and heart function of patients with acute decompensated heart failure， and effectively relieve dyspnea， lung rales and systemic edema. It is better than routine treatment in prognosis with good safety.