Association Of Tissue Factor And Tissue Factor Pathway Inhibitor With Unstable Angina Pectoris And Primary Study Of Mechanism

Objectives:To observe the changes of tissue factor(TF)and tissue factor pathway inhibitor(TFPI)and inflammation response in unstable angina pectoris patients,to investigate the association of TF and TFPI with unstable angina pectoris, to study the mechanism through experiments in vitro.Methods:(1)Clinical study:65 cases diagnosed unstable angina pectoris(UAP) patients with angiographically and clinically and 63 cases diagnosed stable angina pectoris(SAP)patients were analyzed.The serum levels of Tissue necrosis factorα,TF,TFPI were measured by ELISA.(2)Experimental study:Vascular endothelial cells taken from over 7-month fetus or newborn baby umbilical cord were incubated in vitro and stimulated by TNFα,then detect the TFPI and TF levels.Results:(1)There were no significance of gender,age,hypertension history,diabetes history,coronary heart disease family history,smoke,the levels of blood lipid,blood glucose,fibrinogen,platelet and hemoglobin between UAP patients and SAP patients(p＞0.05).The number of white blood cells in UAP patients was significantly higher than which in SAP patients.(2)The TNFαlevel in UAP patients was 17.541±6.690 ng/L and in SAP patients was 13.712±4.342 ng/L.The TNFαlevel was significantly higher in UAP patiens than which in SAP patients(p＜0.01).(3)The TF and TFPI levels in UAP patients were 90.212±15.019 ng/ml and 92.657±24.621 ng/ml and in SAP patients were 79.132±13.125 ng/ml and 75.592±21.438 ng/ml.The TF and TFPI levels in UAP patients were significantly higher than those in SAP patients(p＜0.01).(4)The levels of TFPI and TF antigen increased when vascular endothelial cells incubated in vitro were stimulated by TNFα,and time-effect association was abserved.The TF level began to obviously increase after 20 minutes of stimulation,and obtained peak at 12 hours.TFPI began to increase after 2 hours of stimulation and obtained peak slowly in 72 hours.Conclusion:(1)The increasing of TF and TFPI levels in unstable angina pectosis patients improve the asscoation of unstable angina incidence with vascular endothelial cells damage and thrombosis.TF and TFPI maybe become the coagulation markers after the damage of the vascular endothelial cells.(2) Inflammation response have directed actions with vascular endothelial cells in local, induce the excretion of TF and TFPI,then start the coagulation and fibribolysis process consequently.The coagulation factors oagulati over-early and relative strong was the important oagulati of local thrombosis.