| Objective: To investigate the expression of TFPI mRNA in activated platelet in patients with CHD and the anticoagulant mechanism of LMWH for them.Methods: In order to undertake a case-control study,37 coronary heart disease (CHD)hospitalized patients diagnosed by coronary angiography(case group) and 31 subjects without CHD (control group)in Fujian provincial hospital were studied.Case group was divided into three groups,AMI,UA and SA group.Basic clinical data such as age,gender,vital sign were collected.Biochemical parameters such as white blood-cell count(WBC),neutroplil%(N%),Platelet count(PLT),Total Protein(TP),Albumin(ALB),Globulin (GLB),Alanine aminotransferase(ALT),Aspartate aminotransferase(AST),Triglyceride(TG),Total cholesterol(TC),High density lipoprotein(HDL),Low density lipoprotein(LDL),Fasting Plasma Glucose(FPG),Blood urea nitrogen(BUN),Serun creatinine(Scr) and Uric acid(UA)were measured. By means of ELISA technique, the levels of free-TFPI were measured in the both groups in the study,before and after LMWH treatment.By means of Trizol astracted the mRNA of platelet,RT-PCR appropriated the aim fragement,Gel Imaging System scanned and semi-quantitative analyzed,the activated pletelet mRNA levels were measured.SPSS 13.0 was used to analyze all the data.Results: 1.The level of age,gender,WBC,N%,PLT,TP,ALB,GLB,ALT,AST,TC,TG,HDL,LDL,FPG,BUN,CR and UA had no significant differences between case group and control group(P>0.05). 2.One-way ANOVA showed that the mRNA expression level of TFPI in platelet in patients with AMI and UA were significant higher than that of control group(P﹤0.05). [1.07,0.92vs 0.64]. Independent-Samples T Test showed that the mRNA expression level of TFPI in platelet with case group were significant higher than that of control group(P﹤0.01). [0.92 vs 0.64] 3.One-way ANOVA showed that level of free-TFPI in patients with AMI ,UA and SA were 92.08,74.91 and 62.76ug/L.The front two groups were significantly higher than the control group whose level was 55.45ug/L.Independent-Samples T Test showed that the average level of FTFPI with case group were significant higher than that of control group(P﹤0.05).[ 77.04ug/L vs55.45ug/L] 4.There were positive correlation between the mRNA expression of TFPI in platelet and the change of plasma free-TFPI in patients with AMI,UA and SA before and after LMWH treatment. Correlation coefficient R were 0.760 and 0.656.5.Paired-Samples T Test showed that after the treatment by LMWH,free-TFPI increased significantly among the AMI,UA and SA group(P<0.01).The average level of FTFPI of those three groups exposured to LMWH were141.87,116.82 and 107.28ug/L,compared with 92.08,74.91,62.76ug/L before treatment. Paired-Samples T Test showed that the average level of free-TFPI after treatment by LMWH were significant higher than that without treatment(P<0.01). [121.85ug/L vs 77.04ug/L].Conclusions:1.The mRNA of TFPI which was one of the major contents in platelet was expressed in platelet of human being.2.CHD had unusually activated hypercoagulative state,which caused the basic plasma FTFPI level elevation.3.The expression of TFPI were enhanced in CHD patient with platelet activation and had correlation to the severity of CHD or activation level of platelet.4.TFPI had relevant to the unique anticoagulant mechanism of LMWH.The plasma FTFPI level further rises obviously after applying LMWH anti-freezing in CHD.5.According to the research of TFPI expression in platelet and anticoagulant mechanism of LMWH,we might provide a new and unique way to study the TFPI and the treatment of CHD.
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