目的　研究心肌细胞坏死在慢性充血性心力衰竭 (CHF)病程中的作用及其可能机制。方法　测定 12 8例 CHF患者血清心肌特异性肌钙蛋白 成分 (c Tn )及肌酸激酶同工酶 MB成分 (CK- MB)含量 ,并以 5 6例健康人作对照。同时 ,检测 CHF患者血浆中肾素活性、血管紧张素 及醛固酮含量。结果　CHF患者血清 c Tn 含量显著高于正常人 ;CHF患者血清 c Tn 含量与其血浆血管紧张素 含量呈正相关 ,与其左室射血分数呈负相关 ;在 CHF患者中 :1血清 c Tn 含量升高亚组临床心功能状况更差 ;2c Tn 升高亚组超声心动图心功能指标更差 ;3c Tn 升高亚组住院期间死亡率更高。结论　 CHF患者有间歇性心肌细胞坏死 ,肾素 -血管紧张素系统参与此过程 Objective To study the role of cardiomyocyte necrosis in the course of chronic congestive heart failure (CHF) and its possible mechanism. Methods Serum cardiac-specific troponin (cTn) and creatine kinase MB content (CK-MB) in 128 patients with CHF were measured and 56 healthy controls were used as controls. Meanwhile, plasma renin activity, angiotensin and aldosterone levels were measured in patients with CHF. Results Serum cTn levels in CHF patients were significantly higher than those in normal controls. Serum cTn levels in CHF patients were positively correlated with plasma angiotensin levels and negatively correlated with left ventricular ejection fraction. In CHF patients, serum cTn levels were increased Subclinical clinical cardiac function worse; 2c Tn increased subgroup of echocardiography worse cardiac function; 3c Tn increased subgroup higher mortality during hospitalization. Conclusions CHF patients have intermittent cardiomyocyte necrosis and the renin-angiotensin system participates in this process