Abstract: OBJECTIVE To explore the association of polymorphisms of B-cell lymphoma-2（Bcl-2） and 1α-hydroxylase gene（CYP27B1）-1260 promoters with susceptibility to pulmonary infection in elderly patients with chronic heart failure. METHODS A total of 301 elderly patients with chronic heart failure who were treated in the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from Oct 2019 to Dec 2021 were enrolled in the study and divided into the infection group with 67 cases and the no infection group with 234 cases according to the status of pulmonary infection. The genotypes of Bcl-2 and CYP27B1-1260 promoters and frequencies of genes were compared between the two groups. Logistic regression analysis was performed for their association with the pulmonary infection in the elderly patients with chronic heart failure. RESULTS Totally 82 strains of pathogens were isolated from 67 patients of the infection group, 60（73.17%） of which were gram-negative bacteria. The results of univariate analysis and multivariate logistic regression analysis showed that the no less than 70 years of age, complication with diabetes mellitus, complication with chronic obstructive pulmonary disease, invasive operation, AA genotype at rs2279115 locus of Bcl-2 gene and CC genotype at CYP27B1-1260 locus were the risk factors for the pulmonary infection in the elderly patients with chronic heart failure. In the infection group, the expression level of peripheral blood Bcl-2 mRNA of the patients with AA genotype at rs2279115 locus of Bcl-2 gene was lower than that of the patients with AC plus CC genotype, the expression level of peripheral blood 1,25（OH）₂D₃ of the patients with CC genotype at CYP27B1-1260 locus was lower than that of the patients with AA plus AC genotype（P＜0.05）. CONCLUSION The AA genotype at rs2279115 locus of Bcl-2 gene and CC genotype at CYP27B1-1260 locus are the risk genotypes for the pulmonary infection in the elderly patients with chronic heart failure.