Aim Through the exoRBase database to screen the differentially expressed exosomal genes and build the CeRNA network in the peripheral blood of coronary heart disease (CHD), and then explore the key genes and regulatory mechanisms leading to the onset and progression of CHD. Through the key genes of differentially expressed mRNA who were enriched by GO and KEGG analysis, to study the molecular function and biological processes of the differentially expressed mRNA in CHD. Methods The R language was used to screen the differentially expressed exosomal genes in the peripheral blood of CHD, and the online databases and Cytoscape software was used to construct the CeRNA networks.And then visualized and analyzed the key genes. In the end, the GO and KEGG enrichment analysis was performed for the differentially expressed mRNA key genes. Results A total of 312 exosomal mRNA, 43 exosomal lncRNA and 85 exosomal circRNA with differential expressed were screened out from the peripheral blood of CHD patients. Through the construction of the CeRNA network, it was found that mRNA, lncRNA and circRNA competitively bound to miRNA, and the expressions of lncRNA combined with miRNA were significantly up-regulated, while the expressions of mRNA and circRNA were mostly significantly down-regulated. The GO and KEGG enrichment analysis of key genes of differentially expressed mRNA showed that these key genes were mainly related to “phosphatase activator activity” and “phosphatase regulatory activity” functions. Conclusions The peripheral blood exosomes screened by exoRBase database in patients with CHD are significantly different from those in healthy people, and mRNA, lncRNA and circRNA can competitively combine with miRNA significantly related to CHD and achieve mutual regulation. These genes may be involved in the occurrence and development of CHD and can be used as its regulatory points and therapeutic drug targets.