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目的探讨钠尿肽对老年重症心力衰竭患者死亡的预测价值。方法选择老年重症心力衰竭患者38例，根据随访结果分为死亡组23例和生存组15例，记录基线资料和临床参数，包括N末端B型钠尿肽前体(NT-proBNP)、肌钙蛋白I(cTnI)、左心室舒张末内径(LVEDD)、左心室射血分数(LVEF)、体质量指数(BMI)，用COX回归分析多个临床参数。结果与生存组比较，死亡组治疗后NT-proBNP[(7519±2519)ng/L vs(2055±1220)ng/L]、cTnI [(1.2±1.2)μg/L vs(0.2±0.4)μg/L]、左心室舒张末内径[(5.8±0.8)cm vs(5.1±1.0)cm]明显升高，LVEF [(36±9)%vs (45±10)%]、体质量指数[(22.0±3.5)kg/m2 vs (24.4±3.0)kg/m2]明显降低，差异有统计学意义(<0.05，<0.01，<0.001)。采用COX回归分析，显示，治疗后NT-proBNP是老年重症心力衰竭患者发生心脏事件死亡独立的预测因子(RR=1.015，95豫CI：1.002~1.037,=0.015)。结论治疗后NT-proBNP水平是预测老年重症心力衰竭患者死亡的独立危险因子。左心室大小、左心室射血分数、cTnI水平、BMI可能是影响老年重症心力衰竭患者死亡的危险因素。“,”Objective To evaluate the predictive value of natriuretic peptide in elderly patients with severe heart failure.Methods This fol ow-up study included 38 elderly patients with severe heart failure treated in Wuhan No7 Hospital. The basal data and clinic parameters were compared between death group and survive group, included NT-proBNP, cTnI, LVEDD, LVEF, BMI. Cox regression were used to detect independent predictive factors of death. Results Compared with survive group, the concentration of NT-proBNP [(7519±2519)ng/L vs(2055±1220)ng/L], cTnI [(1.2±1.2)μg/L vs (0.2±0.4)μg/L], the diameter of left ventricular [(5.8±0.8)cm vs(5.1±1.0)cm] were biggerincreased significantly in death group after treatment, left ventricle ejection fraction[( 36±9 )%vs ( 45±10 )%] and body mass index [(22.0±3.5)kg/m2 vs ( 24.4±3.0 )kg/m2] were lower in death group,( <0.05,<0.01,<0.001). The concentration of NT-proBNP after treatment was the independent predictor of death in elderly patients with sever heart failure from Cox regression model( RR=1.015,95%CI:1.002~1.037, =0.015 ).Conclution The concentration of NT-proBNP after treatment is the independent predictor of death in elderly patients with sever heart failure. The diameter of left ventricular, left ventricle ejection fraction and the concentration of cTnI after treatment, body mass index may be the risk factors of death in elderly patients with sever heart failure.