目的：回顾性分析接受A型肉毒毒素（botulinum toxin type A，BTX-A）注射治疗的偏侧面肌痉挛患者的临床特征。

方法：对单中心245例接受BTX-A注射治疗的偏侧面肌痉挛患者进行回顾性研究，分析人口统计学特征和临床特征，以及与Cohen痉挛强度分级和BTX-A注射疗效的关联。

结果：245例偏侧面肌痉挛患者中，女性为159例（64.9%），就诊时平均年龄为54.2±10.3岁；男性为86例（35.1%），就诊时平均年龄为48.3±8.6岁。137例（55.9%）为左侧面肌痉挛，其中女性患者97例[ 占女性患者的61.8%（97/159）]，男性患者40例[ 占男性患者的46.5%（40/86）]。根据Cohen痉挛强度分级，轻度痉挛患者51例（20.8%），中至重度痉挛患者194例（79.2%）；与轻度痉挛患者相比，中至重度痉挛患者的年龄较大（P＝0.021），病程较长（P＝0.012）。偏侧面肌痉挛伴同侧耳鸣患者48例（19.6%），其中46例（95.8%）为中至重度偏侧面肌痉挛。轻度偏侧面肌痉挛患者的BTX-A平均注剂量为35.5±5.2 U，平均疗效持续时间为145.5±36.1 d；中至重度偏侧面肌痉挛患者的BTX-A平均注射剂量为40.2±5.8 U，平均疗效持续时间为137.8±34.5 d。治疗后4周时随访，总有效率为96.3%，视觉模拟评分法（visual analog scale，VAS）治疗满意度平均为75%。

结论：偏侧面肌痉挛女性患病率显著高于男性，并且左侧患病比例也高于男性；中至重度偏侧面肌痉挛患者占比较高，并且与同侧耳鸣症状相关；所有患者均对BTX-A注射治疗反应良好，且不良反应轻微，能够显著提升患者的工作和生活质量。

Objective: To retrospectively analyze the clinical characteristics of patients with hemifacial spasm who received botulinum toxin type A (BTX-A) injection.

Methods: A retrospective study was conducted in 245 patients with hemifacial spasm who received BTX-A injection in a single center. The demographic and clinical characteristics were analyzed, and the correlations with Cohen’s scale and the efficacy of BTX-A injection was analyzed.

Results: Among 245 patients with hemifacial spasm, 159 patients (64.9%) were females with an average age of 54.2 ± 10.3 years; 86 patients (35.1%) were males, with an average age of 48.3 ± 8.6 years. Left hemifacial spasm was seen in 137 patients (55.9%), including 97 females (61.8% of female patients, 97/159) and 40 males (46.5% of male patients, 40/86). According to Cohen’s scale, 51 (20.8%) had mild spasm, 194 (79.2%) had moderate-severe spasm; compared with mild spasm, patients with moderate-severe spasm had older age (P = 0.021) and longer course of disease (P = 0.012). The average injection dose of BTX-A in mild hemifacial spasm patients was 35.5 ± 5.2 U, and the average duration of efficacy was 145.5 ± 36.1 d; the average injection dose of BTX-A in patients with moderate-severe hemifacial spasm was 40.2 ± 5.8 U, and the average duration of efficacy was 137.8 ± 34.5 d. Four weeks after treatment, the total response rate was 96.3%, and the visual analog scale (VAS) score of treatment satisfaction was 75%.

Conclusion: The prevalence of hemifacial spasm in females is significantly higher than that in males, and the proportion of left side involvement is also higher than that of males; patients with moderate-severe hemifacial spasm accounts for a high proportion, and is related to clicking sounds in the ipsilateral ear. All patients had good response to BTX-A injection with less adverse reactions, so as to significantly improve the quality of work and life.