冠心病活化血小板内TFPI的表达及低分子肝素对其抗凝机制的作用

Expression of Tissue Factor Pathway Inhibitor(TFPI)mRNA in activated platelet in coronary heart disease(CHD) and the anticoagulant mechanism of low molecular weigh heparin(LMWH)for them

目的探讨冠心病患者活化血小板内组织因子途径抑制剂(TFPI)的表达及其与低分子肝素(LMWH)抗凝机制的关系。方法用RT-PCR和ELASA法对急性心肌梗死(AMI)、不稳定型心绞痛(UA)、稳定型心绞痛(SA)患者及正常对照组(CG)进行血小板内TFPI水平和mRNA及三组患者应用LMWH前后血浆游离组织因子途径抑制剂(FTFPI)水平的检测。结果 (1)AMI组、UA组血小板内TFPI mRNA的表达升高,与对照组比较,差异有统计学意义(P<0.05)。(2)AMI组、UA组和SA组的FTFPI水平分别为93.39、74.91、62.98μg/L,与对照组相比,前两组水平明显升高。(3)血小板TFPI mRNA的表达与AMI组、UA组、SA组血浆FTFPI水平具有良好的相关性。(4)三组患者应用LMWH后,FTFPI水平分别为141.87、116.82、107.28μg/L,与治疗前相比,差异有统计学意义(P<0.01)。结论冠心病患者活化血小板内TFPI mRNA的表达升高,并且血小板内TFPI参与LMWH的抗凝机制。

Objective To investigate the expression of TFPI mRNA in activated platelet in CHD and the anticoagulant mechanism of LMWH for them. Methods By means of RT - PCR method and ELASA technique,the activated pletelet mRNA levels and the levels of free -TFPI were measured in patient with stable angina （SA） group,unstable angina （UA） , acute myocardial infarction （AMI） and control group in the study. Results （ I ） The mRNA expression level of TFPI in platelet were signifeieant higher in patient with AMI and UA than tbat of healthy survey（ P 〈 0. 05 ）. （2） Contrasting to the control group, the level of free - TFPI in patient with AMI or UA were significantly higher （ P 〈 0.01 ）. The average level of FTFPI of those three groups were 93.39,74. 91 and 62.98 μg/L. （3）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. （4）After the treatment by LMWH, free - TFP1 increased significantly among the AMI,UA and SA group. The average level of FTFPI of those three groups exposured to LMWH were 93.39,74.91 and 62.98μg/L. Conclusion The expression of TFPI were enhanced in CHD patient owing to platelet activation. TFPI were released from the pool of platelet into circulation when exposure to LMWH.