不同责任血管所致面肌痉挛与原发性高血压的相关性分析

Analysis of the correlation between hemifacial spasm with different offending vessels and essential hypertension

目的 分析不同责任血管所致面肌痉挛（HFS）与原发性高血压（HTN）的相关性.方法 回顾性纳入武警后勤学院附属医院脑科中心2014年11月至2016年4月采用显微血管减压术（MVD）治疗的267例HFS患者,其中88例合并HTN（合并HTN组）,179例不合并HTN（不合并HTN组）.按照责任血管类型将HFS患者分4组,分别为小脑前下动脉（AICA）组（114例）、小脑后下动脉（PICA）组（85例）、椎-基底动脉（VA）组（49例）和复合动脉（MA）组（19例）.其中88例合并HTN的HFS患者按照责任血管类型也分4组,分别为HTN-AICA组（32例）、HTN-PICA组（24例）、HTN-VA组（22例）和HTN-MA组（10例）.比较合并HTN和不合并HTN组间的临床资料,分析HFS患者发生HTN的影响因素及不同责任血管类型的HFS患者与HTN发生的相关性.结果 合并HTN组和不合并HTN组患者的性别、HFS的侧别、病程、MVD有效率和复发率的差异均无统计学意义（均P〉0.05）,合并HTN组的年龄和发病年龄均大于不合并HTN组（均P〈0.001）.多因素分析显示,HFS的发病年龄是HTN发生的影响因素（P〈0.001）,且HFS发病年龄每增加1年,HTN的发病风险增加1.098倍.MA、VA组HFS患者HTN的发生率高于AICA、PICA组（分别为52.6％、44.9％、28.1％和28.2％,P=0.035）,VA组患者左侧的HTN发生率高于右侧（分别为54.3％、21.4％,P=0.033）.合并HTN的4组患者,年龄、性别、HFS发病年龄和病程、HTN的发病年龄和病程之间的差异均无统计学意义（均P〉0.05）.结论 HFS的发病年龄是HTN发生的影响因素,责任血管为VA和MA的HFS患者合并HTN的比例更高,且责任血管为左侧VA的患者更易并发HTN.

Objective To investigate the correlation between hemifacial spasm （HFS） with different offending vessels and essential hypertension （HTN）.Methods A retrospective analysis was conducted on 267 patients of HFS who underwent microvascular decompression （MVD） from November 2015 to April 2017 at Neurosurgery Department of Affiliated Hospital of Logistics University of Chinese People＇s Armed Police Force.A total of 88 cases had the comorbidity of HTN （HTN group）,and 179 cases had no HTN （non-HTN group）.The HFS patients were divided into 4 groups based on the offending vessels：anterior inferior cerebellar artery （AICA） （n =114）,posterior inferior cerebellar artery （PICA） （n =85）,vertebral artery （VA） （n =49） and multiple artery （MA） groups （n =19）.Patients with HTN were also divided into 4 groups according to the offending vessels：HTN-AICA （n =32）,HTN-PICA group （n =24）,HTN-VA （n =22） and HTN-MA groups （n =10）.The classifications as above were to analyze influencing factor of the incidence of HTN among HFS patients and correlation between HFS with different offending vessels and HTN by comparing the clinical data between HTN and non-HTN groups.Results There was no statistical difference in the sex,side of HFS,course of HFS,effect and recurrence at follow-up between HTN and non-HTN groups （all P 〉 0.05）.The patient＇s age and onset age of HFS in HTN group was significantly higher than those in non-HTN group （both P 〈0.001）.Logistic analysis showed that the HFS onset age was the influencing factor for the incidence of HTN （P 〈 0.001）,and the risk of HTN was elevated by 1.098 times as the HFS onset age increased by 1 year.The incidences of HTN in MA and VA groups were higher than those in AICA and PICA groups （52.6%,44.9%,28.1% and 28.2%,respectively,P =0.035）.There was no statistical difference in the age,sex,HFS onset age and course of HFS,HTN onset age and course of HTN between the 4 HTN groups （all P 〉 0.05）,while the side of HFS was statistically different and there were more left-sided than right-sided patients in VA group （P =0.033）.Conclusions The HFS onset age is suggested to be an influencing factor of the incidence of HTN.The proportion of HTN was higher in VA and MA groups,and left-sided VA patients are more likely to present comorbidity of HTN.