冠状动脉痉挛患者自主神经功能及其相关基因多态性分析-内科学(心血管病)专业论文.docxVIP

第三军医大学博士学位论文 第三军医大学博士学位论文 PAGE PAGE 2 PNN50 proportion of NN intervals differing more than 50ms to the total number of NN intervals 相邻 NN 间期相差50 ms 的百 分数 PSV peak systolic velocity 收缩期峰值血流速度 rMSSD the root mean square of difference between adjacent NN intervals SDNN standard deviation of normal-to-normal intervals SDANN standard deviation of the average of NN intervals in all 5-minutes of the entire recording 相邻 NN 间期差值的均方根值 NN 间期标准差 每 5min 内 NN 间期均值的标准差 TP total power 总功率 VLF very low frequency 极低频功率 VSMCs vascular smooth muscle cells 血管平滑肌细胞 Investigation on the Activity of the Autonomic Nervous System and the Related Genetic Polymorphism in Patients with Coronary Artery Spasm Abstract Coronary artery spasm (CAS) is one of the leading pathological causes of a wide spectrum of ischemic heart diseases, ranging from variant angina pectoris to acute myocardial infarction and even sudden cardiac death. However, the exact mechanism of CAS is still not well understood. Recent studies have identified a number of precipitating factors that may play a role in the pathogenesis of CAS, which include endothelial dysfunction, smooth muscle cell hypersensitivity, increased oxidative stress, inflammation, genetic susceptibility and autonomic nerves system dysfunction. With the study extends, the role of autonomic nerves system dysfunction in the pathogenesis of CAS becomes a subject to be increasing noticed. A large number of studies have consistently demonstrated that patients with CAS had autonomic nervous system disorder. However, which of the autonomic nerves system dysfunction, the sympathetic dysfunction or the vagal dysfunction plays a major role is still a dispute. This also suggested that the role of the autonomic nervous system dysfunction in the mechanism of CAS may be complex and varied. Heart rate variability (HRV), as a non-invasive method, is the most sensitive indicator to evaluate autonomic nervous function. Our previous study investigated the char