关键词: 面部单侧痉挛, 高血压, 延髓, 血管压迫

Abstract: Objective　To explore the correlation between primary hypertension and vascular compression of the left rostral ventrolateral medulla（VCLRVM） among patients with primary hemifacial spasm（HFS）.Methods　The participants were enrolled from Department of Neurosurgery，the First Affiliated Hospital of Xinjiang Medical University from October 2014 to October 2017，consisting of 205 cases of primary HFS〔110 with left hemifacial spasm（including 35 with primary hypertension） and 95 with right hemifacial spasm（including 45 with primary hypertension）〕，and age- and sex-matched 205 with other cranial nerve diseases（control group） including 60 with primary hypertension.All of them underwent MRI of the internal auditory canal with 3D-FIESTA for identifying the status of VCLRVM.The association between primary hypertension and the prevalence of VCLRVM was investigated by intragroup and intergroup comparisons.Results　In the control group，the left and bilateral RVLM NVC rates of patients with essential hypertension were higher than those without essential hypertension，and the right RVLM NVC rates were lower than those without essential hypertension（P < 0.05）.In the control group，primary hypertension was found to be associated with higher prevalence of vascular compression of the rostral ventrolateral medulla（VCRVM）〔71.7%（43/60）vs 35.9%（52/145）〕（χ2=21.879，P<0.001）. The left RVLM NVC rate of patients with essential hypertension in left HFS subgroup was higher than that of patients without essential hypertension（P < 0.05）. In the left hemifacial spasm subgroup，primary hypertension was identified to be associated with higher prevalence of VCRVM〔91.4%（32/35）vs 46.7%（35/75）〕（χ2=20.081，P<0.001）.Furthermore，it was also associated with higher prevalence of VCLRVM（P<0.05）.In the right hemifacial spasm subgroup，primary hypertension was also found to be associated with higher prevalence of VCRVM〔77.8%（35/45）vs 46.0%（23/50）〕（χ2=10.058，P=0.002）. The left RVLM NVC rate of patients with essential hypertension in right HFS subgroup was higher than that of patients without essential hypertension（P < 0.05）.Compared with the controls，the prevalence of VCLRVM was higher in those with both primary hypertension and left hemifacial spasm（χ2=10.140，P=0.001）.However，the prevalence of VCRRVM in those with both primary hypertension and right hemifacial spasm was similar to that of the controls（χ2=2.917，P=0.088）.Conclusion　VCLRVM was more common in patients with both primary hypertension and left primary HFS.Moreover，it showed a correlation with the primary hypertension.

Key words: Hemifacial spasm, Hypertension, Medulla oblongata, Neurovascular compression