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

摘要： 目的　探究原发性面肌痉挛（HFS）患者原发性高血压病与左侧延髓头端腹外侧区（RVLM）血管压迫（NVC）的相关性。方法　选取2014年10月—2017年10月在新疆医科大学第一附属医院神经外科就诊的符合研究标准原发性HFS患者205例作为原发性HFS组，其中原发性高血压病患者80例。原发性HFS组患者再分为左侧HFS亚组（n=110）和右侧HFS亚组（n=95），其中分别包含原发性高血压病患者35、45例。按照性别、年龄匹配的原则，另选取同期在本科室就诊的颅神经疾病患者205例作为对照组，其中原发性高血压病患者60例。患者均行头颅内听道核磁共振（MRI）3D薄层扫描成像，通过MRI扫描成像对RVLM NVC情况进行评估。比较对照组、左侧HFS亚组、右侧HFS亚组有无原发性高血压病患者RVLM NVC情况，以及对照组与左、右侧HFS亚组有原发性高血压病患者左侧RVLM NVC情况。结果　对照组中有原发性高血压病患者左侧、双侧RVLM NVC率高于无原发性高血压病患者，右侧RVLM NVC率低于无原发性高血压病患者（P<0.05）；对照组中有原发性高血压病患者RVLM NVC率为71.7%（43/60），高于无原发性高血压病患者的35.9%（52/145）（χ2=21.879，P<0.001）。左侧HFS亚组中有原发性高血压病患者左侧RVLM NVC率高于无原发性高血压病患者（P<0.05）；左侧HFS亚组中有原发性高血压病患者RVLM NVC率为91.4%（32/35），高于无原发性高血压病患者的46.7%（35/75）（χ2=20.081，P<0.001）。右侧HFS亚组中有原发性高血压病患者左侧RVLM NVC率高于无原发性高血压病患者（P<0.05）；右侧HFS亚组中有原发性高血压病患者RVLM NVC率为77.8%（35/45），高于无原发性高血压病患者的46.0%（23/50）（χ2=10.058，P=0.002）。左侧HFS亚组有原发性高血压病患者左侧RVLM NVC率高于对照组（χ2=10.140，P=0.001）。对照组与右侧HFS亚组有原发性高血压病患者左侧RVLM NVC率比较，差异无统计学意义（χ2=2.917，P=0.088）。结论　左侧RVLM NVC在左侧原发性HFS伴原发性高血压病患者中更为常见，且其与原发性HFS患者发生原发性高血压病存在一定关系。

关键词: 面部单侧痉挛, 高血压, 延髓, 血管压迫