目的　观察原发性高血压患者室性早搏( 简称室早) 的发生特点,为临床治疗提供依据。方法　选取住院时同步接受动态心电图和动态血压监测的200 例原发性高血压患者,观察室早与24 h 血压、血压昼夜节律变化、左心室肥厚、心肌缺血以及心功能间的关系。结果　① 伴和不伴室早的原发性高血压患者,其24 h 血压差异无统计学意义;室早Lown 分级≥3 级的患者,其24 h 平均收缩压、白天及夜间平均收缩压均高于3 级以下的患者。② 伴有心肌缺血或左心室肥大的患者室早总发生率及室早Lown 分级≥3 级的发生率均高于无心肌缺血或无左心室肥大的患者。③ 合并心力衰竭( 简称心衰) 的患者室早总发生率和室早Lown 分级≥3 级的发生率均高于无心衰的患者;在心衰患者中NYHA 心功能分级≥Ⅲ级者室早总发生率和室早Lown 分级≥3 级的发生率均高于Ⅲ级以下的患者。结论    血压昼夜节律减弱或消失、伴有左心室肥大和心肌缺血、合并心衰的原发性高血压患者,室早的发生率及复杂程度更高。

Objective　To observe the characteristics of essential hypertension(EH) patients with premature ventricular contraction ( PVC), and provide references for clinical treatment. Methods 　Two hundred EH patients who had undergone Holter and ambulatory blood pressure monitoring during hospitalization were selected. The relationship between PVC, and 24 h blood pressure, changes of blood pressure circadian rhythm, left ventricular hypertrophy, myocardial ischemia and cardiac function was observed. Results 　(ⅰ) There is no statistical difference of 24 h blood pressure between EH patients with and without PVC. In the patients with Lown classification grade 3 and above, the 24 h average systolic blood pressure (SBP), and day and night average SBP are all higher than those in the hypertensives below grade 3. (ⅱ) Among the patients with myocardial ischemia or left ventricular hypertrophy, the total incidence of PVC, and the incidence of PVC Lown classification grading 3 and above are both higher than those in the patients without myocardial ischemia or left ventricular hypertrophy.(ⅲ) Among the patients complicating heart failure, the total incidence of PVC, and the incidence of PVC Lown classification grading 3 and above are both higher than those in the patients without heart failure. In the heart failure patients with NYHA cardiac function classification of Ⅲ and above, the total incidence of PVC, and the incidence of PVC Lown classification grading 3 and above are both higher than those in the patients below NYHA classification of Ⅲ. Conclusion In EH patients, weakened or disappeared circadian rhythm of blood pressure, and complication of left ventricular hypertrophy or myocardial ischemia and heart failure, the incidence and complexity of PVC increase.