Coagulogram - what kind of analysis is it, the correct interpretation of the results. Coagulogram: essence and indications for research, parameters, how and where to take Normal coagulogram indicators
A coagulogram is a set of blood parameters indicating the clotting process. Since coagulation has a protective function, that is, it provides normal hemostasis, the analysis has a second name - hemostasiogram, coagulation hemostasis. Although the clotting system is not the only support mechanism of the body. Primary hemostasis is provided by platelets and vascular properties.
Increased coagulability (hypercoagulability) leads to thrombosis during bleeding, but can cause pathology in the form of thrombosis and thromboembolism.
Decrease (hypocoagulation) occurs with bleeding but is used in a controlled manner to treat thrombosis.
All indicators that make up the blood coagulogram are indicative. For a complete assessment, a study of clotting factors is necessary. There are only thirteen of them, but the insufficiency of each leads a person to serious problems.
Indications for research
In medical practice, there are situations when it is necessary to focus on the patient. A blood test for a coagulogram is prescribed:
- if a person has clear signs of frequent bleeding, bruises on the skin from the slightest bruises;
- in preparation for surgical treatment;
- with diseases of the liver, heart and blood vessels;
- to study the causes of damage to the immune defense mechanism;
- to control the condition of a pregnant woman.
Coagulation studies are necessary for the selection of a drug in therapy that reduces this property of the blood, with a tendency to vascular thrombosis (ischemic heart disease, stroke, varicose veins, cardiac arrhythmias). In these diseases, a control analysis is carried out to check the effect of the drugs.
Rules for donating blood for a coagulogram
The price of an erroneous analysis is severe bleeding or, conversely, vascular thrombosis with the development of impaired blood supply to the organ.
To ensure the reliability of obtaining indicators, blood sampling for a coagulogram is carried out only if the necessary conditions are met:
- they take blood on an empty stomach - this means that the patient should not eat from 8 to 12 hours, a light dinner is allowed the night before, it is strictly forbidden to take alcoholic beverages (including beer);
- you can not drink tea, coffee, juices an hour before taking blood;
- it is proposed to drink a glass of plain water immediately 15-20 minutes before entering the treatment room;
- physical activity, hard work are not recommended;
- should be warned about the constant use of anticoagulants.
Coagulogram analysis is performed from venous blood
General requirements for any analysis:
- you can not donate blood against the background of a stressful situation, fatigue;
- in case of dizziness from the type of blood and injections, a medical worker should be warned (the analysis is taken with the patient lying on the couch).
The best time to take the test is in the morning, after a good night's sleep, before breakfast.
Minimum set of indicators
A detailed coagulogram includes many indicators. It is used to diagnose a number of hereditary diseases. Not all hospital laboratories are able to determine every test. This requires special equipment.
Therefore, in practice, the analysis includes the optimal set, which makes it possible to judge, along with indicators of primary hemostasis (platelet count, bleeding time, capillary resistance, clot retraction), about the coagulation properties of blood.
What provides the minimum information about clotting? Consider the most popular indicators, their standards and options for deviations.
clotting time
2 ml of blood is taken from the cubital vein. Without the addition of stabilizing substances, it is poured in 1 ml into two test tubes, which are placed in a water bath to simulate body temperature. The stopwatch starts immediately. The tubes are slightly tilted and the formation of a clot is monitored. A reliable result is considered to be the average obtained over the time of two test tubes.
The norm ranges from five to ten minutes.
The prolongation of the clotting time to 15 minutes or more indicates a deficiency of the prothrombinase enzyme, a deficiency of prothrombin and fibrinogen, vitamin C. This is an expected consequence of the action of the administered heparin, but an undesirable (side) effect of contraceptives.
The simplified method is to use one tube, the result will be less accurate.
Prothrombin index (prothrombin time)
The essence of the method: the study is carried out according to the previous scheme, but a solution of calcium chloride and a standard solution of thromboplastin are added to the test tube. The ability to clot in the presence of a sufficient amount of thromboplastin is checked.
The norm is from 12 to 20 seconds.
The lengthening of time indicates trouble in the synthesis of the prothrombinase enzyme, the formation of prothrombin and fibrinogen. Chronic liver diseases, vitamin deficiencies, malabsorption in the intestines, and dysbacteriosis lead to a similar pathology.
The same effect occurs during treatment (Neocoumarin, Fenilin, Sinkumar). Carrying out therapy requires monitoring the effectiveness of these drugs. A sufficient dosage is considered at which the prothrombin time increases by no more than two times. Otherwise, it creates the possibility of bleeding. Increase the rate of hormonal contraceptives.
The result in the form of an index is expressed as a percentage of the standard plasma prothrombin time to the patient's result. In healthy people, it is 95-105%. The decrease in the index has a similar meaning with the prolongation of the prothrombin time.
Activated partial thromboplastin time (APTT)
The determination of APTT is a modification of the plasma recalcification reaction with the addition of phospholipids (erythrophosphatide or cephalin standard solution). Allows you to identify the insufficiency of plasma coagulation factors, is considered the most sensitive indicator of the coagulogram.
Research sometimes requires a few drops of blood
Normal value: 38-55 seconds.
Shortening the value is considered a risk factor for the development of thrombosis. Lengthening is observed during treatment with heparin or with a congenital deficiency of clotting factors.
Plasma fibrinogen
The definition of fibrinogen is based on the ability to turn into fibrin when special agents are added. The fibrin strands are transferred to the filter and weighed or converted into a colored solution by dissolution. Both methods allow you to quantify the indicator.
Normal is from 5.9 to 11.7 µmol/l (2.0-3.5 g/l).
A decrease in fibrinogen is observed in congenital diseases called fibrinogenemia, severe liver damage.
The indicator increases with infectious diseases, malignant tumors, chronic inflammatory diseases, thrombosis and thromboembolism, after injuries, childbirth and surgical operations, with hypofunction of the thyroid gland.
In babies, the rate of the indicator is lower, so in newborns, the amount of fibrinogen is 1.25-3.0 g / l.
A test for fibrinogen B is carried out. In a healthy person, it is negative.
Extended coagulogram indicators
Diagnosis of diseases requires a more accurate determination of the affected link in the entire coagulation system. To do this, it is necessary to determine additional components of the coagulogram.
thrombin time
The essence of the technique: the ability of plasma to coagulate by adding a standard active solution of thrombin is determined.
The norm is 15-18 seconds.
An increase in time is observed with hereditary fibrinogen deficiency, increased intravascular coagulation, liver tissue damage. The method is common in the treatment of drugs from the group of fibrinolytics and heparin.
Model form listing all extended study results
Blood clot retraction
The method is very similar to the previous one, but it determines not only the coagulation of the clot, but also its degree of compression. The answer is given in a qualitative definition (0 - absent, 1 - available) and quantitatively (the norm is from 40 to 95%).
A decrease in the retraction index occurs with thrombocytopenia. Growth is characteristic of various anemias.
Plasma recalcification time
The essence of the method: plasma and calcium chloride solution are mixed in a water bath in a ratio of 1: 2, the time of the appearance of a clot is recorded with a stopwatch. The study is repeated up to three times and the average result is calculated.
The normal value is 1-2 minutes.
The shortening of time indicates the hypercoagulable properties of the blood.
Elongation is recorded with congenital insufficiency of plasma coagulation factors, the presence of a drug such as heparin in the blood, and thrombocytopenia.
Thrombotest
The analysis is a qualitative visual assessment of the presence of fibrinogen in the blood. Thrombotest grade 4-5 is normal.
Plasma tolerance to heparin
The test shows how quickly a fibrin clot is formed with the addition of heparin to the test blood.
Normally, this happens after 7-15 minutes.
With a lengthening of the indicator, they speak of reduced tolerance to heparin. Often seen in liver disease. If the tolerance is less than seven minutes, hypercoagulation may be suspected.
fibrinolytic activity
The analysis allows you to evaluate the blood's own ability to dissolve blood clots. The indicator depends on the presence of fibrinolysin in the plasma.
The norm is from 183 minutes to 263. If the result is reduced, this indicates increased bleeding.
The value of the coagulogram during pregnancy
Simultaneously with the indicators of the coagulogram in pregnant women, the group and the Rh factor are checked
The physiological restructuring of the blood circulation of a pregnant woman requires an additional volume of blood, a new placental circulation, the production of additional cells and substances responsible for hemostasis of the mother and fetus.
To control the normal development during pregnancy, a coagulogram analysis is prescribed every trimester. As a rule, coagulability increases slightly. It is the body of a pregnant woman that protects itself from blood loss. Deciphering indicators allows you to prevent:
- thrombotic complications (thrombosis of the veins of the extremities);
- possible miscarriage;
- timely diagnosis of placental abruption;
- prepare for childbirth.
Even a large amount of coagulogram indicators is insufficient for diagnosing congenital diseases. Clotting factor studies are being added.
Evaluation of the indicator requires a comparison of individual groups of tests, taking into account biochemical blood tests, and knowledge of characteristic changes in chronic diseases.
Blood is one of the most important fluids in the human body, sensitively reacting to the slightest changes in the state of his health and allowing you to quickly identify existing problems.
Numerous blood tests can quickly give the specialist a fairly complete picture of the existing changes, which means that in the shortest possible time, move on to an in-depth study or to the direct treatment of the disease, if it can be “calculated” immediately. One of these important is the coagulogram.
Coagulogram - a study of blood clotting
A coagulogram is a rather complicated laboratory study of a blood sample for. This procedure makes it possible to find out if there are any disturbances in the work of the blood coagulation system in the direction of accelerating or slowing down the process. Such a study is very important not only for calculating certain ones, but also simply necessary, for example, before an extensive surgical intervention. It will demonstrate how well and quickly the blood can clot during the operation, whether there are problems with accelerated clotting, that is, the formation of blood clots, and whether there will be complications during the intervention if the blood coagulates slowly and with difficulty.
Violation of the thrombosis process can lead to internal and external bleeding, and in case of serious problems, lead to large blood loss or death - the patient can simply bleed out.
Samples for coagulogram norms are necessary not only for the planned surgical intervention, but are also a mandatory study during.
The balance in the blood coagulation system is extremely important for the health of the expectant mother and child, because the slightest violation can cause miscarriage, premature birth or developmental pathologies.Pregnancy creates a serious burden on a woman's circulatory system, so clotting problems can lead to bleeding, placental abruption and be an extremely dangerous factor during childbirth or immediately after them. Uncontrolled severe bleeding can cause severe, up to removal for health reasons.
Coagulogram indicators
What is included in the coagulogram - a description of the indicators
Any analysis for coagulogram norms can be basic or additional, additionally detailed.
The basic indicators include the following parameters:
- fibrinogen. This is the main and most important indicator in the blood coagulation test.
- Prothrombin index, international normalized ratio of INR, PTT prothrombin time. Under normal conditions, one of these three types of samples is performed, most often it is the INR as the most informative and versatile analysis. All of these are directed to the extrinsic pathway of blood clotting.
- thrombin time.
- Activated partial thromboplastin time aPTT.
Additional coagulation parameters:
- Antithrombin. An important indicator of the normal operation of the anticoagulation system.
- Protein C. Lack of this substance can cause thrombosis.
- Lupus anticoagulant. An indicator of the presence of autoimmune problems.
- D-dimer.
- Activated recalcification time (ART).
- Soluble fibrin-monomeric complexes (SFMK).
Appointment for analysis
A test for coagulogram norms is prescribed in different cases, it is necessary for the patient's condition and for assessing potential risks during surgery.
It is carried out not only for patients - all pregnant women receive a referral for such an analysis once a trimester, and if a woman has already had miscarriages or there is a threat of pregnancy loss, there is a risk of developing dangerous conditions, then the test can be carried out unscheduled and repeatedly.
The main reasons for the appointment of a coagulogram are the following diseases and conditions:
- Planned surgery. Almost any operation, especially an extensive one, is associated with the risk of blood loss, and if there is a clotting disorder, such an invasion threatens with dangerous bleeding.
- Violations of the normal functioning of the vascular system, including varicose veins and thrombosis.
- . Throughout the entire period, samples are routinely taken once a trimester.
- Problems with blood clotting.
- The presence of autoimmune diseases.
- Diseases of the cardiovascular system (stroke, heart attack, coronary heart disease).
- Diseases.
- Appointment of oral and other types of hormonal contraceptives. The sample is taken quarterly.
- Prescription and choice of anticoagulant drugs.
- Appointment of an adequate dose of acetylsalicylic acid (aspirin).
During hirudotherapy (the use of leeches for therapeutic purposes). This is necessary to prevent possible blood loss in case of blood clotting disorders, since leeches secrete a special substance that prevents clotting.
A coagulogram, which is also called a hemostasiogram, can be basic and extended.
During the initial examination, a base sample is first assigned, and if necessary, an extended test is prescribed to clarify the result or more accurately determine the pathology.
Sample preparation and procedure
Before performing a coagulogram on the norm, the patient must undergo special training. First of all, the test is taken on an empty stomach, preferably in the morning, so the last dinner can be no later than 8 hours before the analysis, and it is best to limit yourself to food for 12 hours. The maximum withdrawal of drugs is recommended, especially those that may affect the state of the blood. If this is not possible, it is necessary to inform the specialist of the list of medications taken.
During preparation for the analysis, the patient should refuse all types of drinks, limiting himself only to clean drinking water. The ban includes not only alcoholic beverages, but also coffee, cocoa, tea, juices - in a word, everything that does not apply to water.
Emotional and physical peace and well-being of the patient is also essential to obtain accurate and correct coagulation results. Doctors recommend avoiding stressful situations in every possible way before analysis, and also not physically loading the body by postponing training or hard work for another time.
Venous blood is taken for the sample.
The analysis is considered quite complex, it evaluates many different components at once. Correct and accurate interpretation of the data can only be given by an experienced specialized specialist.
Decryption: norm
Since many indicators are taken into account when analyzing the norms of the coagulogram, each of them is an integral part of the overall indicator of the normal functioning of the human circulatory system:
- fibrinogen. The rate of this, which is synthesized in, is 2-4 g / l. In the process of development, the level of fibrinogen increases, but normally in the last trimester it should not exceed 6 g / l (at this time, the maximum increase in this indicator is observed). The level of fibrinogen is a sensitive indicator of the state of the body. It clearly demonstrates the presence of various inflammatory processes in the body, since the level of fibrinogen rises rapidly with the appearance of necrotic tissue conditions (heart attack, stroke, pneumonia, and so on).
- APTT. This indicator determines the time it takes for a blood clot to form. The usual rate is 20-40 seconds.
- Prothrombin. This one interacts with vitamin K, which is very important for the health of the blood and the whole organism. In the liver, they combine and form thrombin.
- thrombin time. This is an indicator of the conversion of fibrinogen into fibrin, normally it should fit in 11-18 seconds. During the amount of fibrinogen increases, however, thrombin time should be within the normal range. If it lengthens or shortens, we can talk about a change in the amount of fibrinogen in the blood (increase or decrease).
- prothrombin time. This factor indicates the timing of the transformation of prothrombin into thrombin. Normally, prothrombin time should take 15-17 seconds. Thrombin is an important substance, it is necessary so that the blood can clot and turn into a clot (thrombus), thereby eliminating bleeding. Both too low and high prothrombin time are equally dangerous.
- Prothrombin index PTI. It is measured as a percentage and is one of the most important indicators of blood clotting. Reflects the comparison of normal plasma coagulation with the same period in the patient (in percentage terms). Normal PTI numbers should not go beyond 93 - 107%. During pregnancy, this figure increases. It can also be affected by taking birth control pills.
- . This is an important indicator that indicates the general condition of the body, and not just the hematopoietic system. Normally, it is 150-400 thousand cells per μl. A low platelet count is called thrombocytopenia and indicates that the expectant mother is not eating well and she needs to urgently change hers so as not to harm the baby.
- Antithrombin. It is a thrombin antagonist, that is, a substance that inhibits blood clotting. Normally, the indicator should be 71 - 115%.
- Lupus anticoagulant. This parameter is very important when conducting tests during pregnancy or assessing the risk of autoimmune diseases. If a woman has preeclampsia, the risk of miscarriage increases significantly. Autoimmune diseases also pose a serious threat to human health and often cannot be detected by any other research.
- D-dimer. This is one of the most important indicators for pregnant women. It is formed by the incomplete breakdown of fibrin. Normally, it is up to 500 ng / ml. In pregnant women, this figure is much higher, even at the very beginning of pregnancy, by the last trimester it increases several times. Also, an excessive deviation of the indicator from the norm may indicate the presence of preeclampsia. In the absence of pregnancy, such indicators appear with, in old age, with damage.
- DIC syndrome. This is a very dangerous condition in which the clotting and blood thinning control system fails and DIC develops. Pregnant, he threatens with endometritis, placental abruption or amniotic fluid embolism.
- Antiphospholipid syndrome, or to phospholipids. Detect an autoimmune disease. Antibodies to phospholipids appear in thrombosis of veins and arteries. A pregnant woman in whom these antibodies are found suffers from fetaplacental insufficiency, which threatens with miscarriage or premature birth, fetal death.
- Plasma tolerance to heparin. It is performed simultaneously with the recalcification time. Heparin is injected into the plasma and the recalcification time is determined. If it deviates from the norm, it may indicate liver disease, heart failure, cancerous tumors and pre-thrombotic conditions. But in pregnant women, the growth of this indicator at the end of pregnancy is normal.
- Plasma recalcification time
- Fibrin clot formation time. The normal indicator is 60 - 120 seconds.
Coagulogram indicators in children are slightly different from those for adults. For example, the level of fibrinogen in a newborn baby is 1.25 - 3 g / l, which is much lower than the standard values of an adult.
Reasons for possible deviations
Deviation of coagulogram indicators - possible diseases
If, after the analysis, various deviations from the norm of the coagulogram are found, this may indicate the presence of various pathologies in the hematopoietic system, and may also be signs of the onset of diseases.
For example, a violation of the normal clotting time indicates a failure in the thrombosis system: the lengthening of this period indicates a decrease in active functioning, an increase in the thrombolytic abilities of the body (that is, that the system to counteract blood clotting is excessively active). If the blood clots very quickly, this indicates a high activity of the blood clotting system or poor performance of the anti-thrombosis system. In order to clarify the specific cause of the violation, it will be necessary to study other indicators of the coagulogram. In addition, in this case, you need to pay attention to which test tube the blood was taken into - glass or silicone. In the case of a silicone tube, the clotting time is extended to 25 minutes, while in glass the maximum is 7 minutes.
The concentration of fibrinogen increases during, with a variety of disorders of the body of an endocrine nature and the presence of various inflammatory processes.
A low level of fibrinogen indicates a violation in the blood coagulation system and is the cause of a variety of bleeding.
Most often, this condition causes, or other diseases, a lack of vitamins C, K and group B in the body, which provokes the development of diseases such as Crohn's disease, a symptom of malabsorption and dysbacteriosis. Also, the cause of such a violation can be the second stage of DIC or the use of special medications.
The time of recalcification is also an important component of the overall picture of the state of the blood and the health of the body. Reducing the period of recalcification indicates thrombophlebitis or thrombosis, and elongation indicates a violation of the blood coagulation system caused by a lack of platelets or their inferiority, as well as disorders of the hemostasis system, increased activity of the anticoagulation system, or in the second stage of DIC.
More information about blood clotting can be found in the video.
If the APTT time is shortened, this does not indicate the presence of serious pathologies, but its lengthening appears when using anticoagulant drugs, with hereditary blood diseases such as hemophilia, or with systemic autoimmune problems.
Violations of the prothrombin index are the most striking indicators of failures in the hemostasis system. A low prothrombin index indicates bleeding disorders caused by a lack of vitamin K, problems with digestion and liver function. An increase in the prothrombin index indicates an increased level of thrombosis associated with thromboembolism of various vessels, strokes and heart attacks.
An increase in thrombin time entails a decrease in the content of fibrinogen, and it is also associated with liver diseases and pancreatitis, with the use of anticoagulants - substances that prevent rapid blood clotting.
Reduction of thrombin time is typical for the third trimester of pregnancy and in conditions that cause an increase in fibrinogen levels.
Deciphering coagulogram data is an important and difficult task, accessible only to a competent and well-trained specialist. No need to try to self-diagnose and even more so, start treatment. The doctor evaluates all paragraphs of the coagulogram as a whole and, if necessary, conducts additional tests and, only after receiving clear data, compiling the desired treatment regimen.
Preparation for a coagulogram does not require much time. The fact is that the procedure is carried out in the morning on an empty stomach. It is desirable that at least 8 hours have passed since the last meal. During this period, drinking water is allowed.
If a person is taking drugs that can affect blood clotting, it is necessary to inform the attending physician. Otherwise, the analysis may not be reliable and, moreover, significantly harm a person.
No other preparation measures are required. It is important simply not to eat before the procedure and not to take special medications. This will allow you to get really correct and reliable results.
A coagulogram is a procedure that every person may need. Therefore, it is desirable to conduct it correctly and treat it with full responsibility. A lot can depend on its result, especially if the date of childbirth or surgery is approaching. A coagulogram is performed in almost every clinic.
Is it possible to eat before a coagulogram?
Many are interested in the question, is it possible to eat before a coagulogram? This procedure is performed exclusively on an empty stomach. Therefore, any meal is prohibited. The only thing allowed is just drinking water.
It is desirable that at least 8 hours have passed since the last meal. The fact is that the procedure is serious and thanks to it you can determine the properties of the blood. Auxiliary components, including sugar, found in food can significantly worsen the result. That is why it is not recommended to eat.
In addition, if a person is taking any medications, it is worth telling the doctor about it. After all, many medicines can affect blood clotting. It is advisable to immediately specify all the nuances so that the procedure goes correctly and gives high-quality results.
As for drinks, it should be exclusively water. Coffee and tea are prohibited. The coagulogram is carried out on an empty stomach in the morning hours.
How to take a coagulogram?
Do you know how to take a coagulogram? Before going to this procedure, you should refrain from eating. It is desirable that the interval was at least 8-12 hours.
Do not drink coffee, tea, juice and alcoholic beverages. If you really want to eat, it is better to drink ordinary water. After the procedure, a person will be able to eat any food. Before the analysis itself, it is advisable to provide a complete list of medications that are taken and used in the last 2-3 days.
At the very moment of surrender, it is necessary that the person be completely calm, not nervous and not worried. The fact is that ordinary muscle tension can significantly affect the results. In order to obtain more accurate parameters, it is necessary to drink a glass of cool water just before the analysis. The procedure is painless and is carried out quite quickly. A coagulogram is a mandatory analysis that must be done before childbirth or surgery.
How to take a coagulogram correctly?
Not many people know how to take a coagulogram correctly. In fact, the procedure is similar to taking blood from a finger, but everything is not so simple. The fact is that before you go for an analysis, it is not recommended to eat. It is desirable that at least 8-12 hours have passed since the last meal. This will give you really accurate results. Many elements found in food can worsen the "reliability" of information.
If you want to eat, it is better to just drink water and be patient. That is why the procedure is carried out in the morning hours. As soon as a person woke up, he should immediately visit the clinic.
The procedure itself is painless and carried out fairly quickly. The main thing is not to eat or drink some drinks, in which case it will be possible to achieve an accurate result. A coagulogram is mandatory if in the near future a person will have to lose a small amount of blood as a result of childbirth or surgery.
Coagulogram during pregnancy
Coagulogram when planning pregnancy
The coagulogram when planning pregnancy is important, because the course of the process, in general, depends on it. Some indicators throughout the entire period of bearing a child can vary and this is quite normal.
But, despite this, a decrease or increase in the level of elements may indicate the presence of deviations. Normal values are very important. After all, during childbirth, a woman loses a small amount of blood. In this matter, much depends on how quickly it collapses.
It should be understood that increased clotting activity can lead to placental abruption and cause severe bleeding. Naturally, there is also a risk of developing blood clots in the placental vessels, which further leads to fetal hypoxia. Therefore, coagulogram studies during pregnancy planning and during childbearing are important. This will avoid many problems and save the baby. A coagulogram should be carried out constantly, this will allow you to monitor changes in blood clotting.
Coagulogram during menstruation
Coagulogram during menstruation is not able to give clear results. The fact is that during this period the blood is diluted and it is not possible to check its ability to coagulate. Therefore, for the procedure, it is advisable to wait for the end of the critical days, but not to take the analysis immediately.
Naturally, such a question can only be clarified by a doctor. He will give some recommendations and advise when it is better to seek help and conduct the necessary analysis. In general, during menstruation, the procedure is not carried out.
The body during this period, on the contrary, is interested in removing excess blood from the uterus, so clotting is somehow impaired. After the critical days, everything returns to normal, and the woman may well be tested. Again, it is also not worth carrying out the procedure just before the menstruation, the body is preparing for the withdrawal process and the blood is gradually thinning. The coagulogram in this case will be unreliable and it will have to be done again.
Coagulogram in children
The coagulogram in children determines the possibilities of blood regarding the coagulation process. It is carried out mainly with suspicion of hemophilia. This analysis is not done so often for children. This is necessary only before surgery, especially if it will be serious.
True, in many cases, this study is asked for help even when excising adenoids or tonsils. This is done in order to calm down and confirm the fact that the child’s blood coagulates perfectly.
The fact is that even a minor intervention can lead to serious bleeding. Stop which will not be so easy and the child may lose a large amount of blood. With elevated rates, surgery is not recommended. This can lead to blockage of blood vessels, which is extremely unacceptable and can lead to serious health problems. Quite often, a coagulogram is performed in children with suspected blood pathology.
Coagulogram in newborns
A coagulogram in newborns is carried out in order to exclude the presence of any blood pathologies. Everything happens on a general basis. Blood is taken from the baby and examined, based on the data obtained, certain results are made. It is enough just to compare the final figures with acceptable standards.
Blood pathologies are not so rare, so this procedure is necessary. Naturally, in isolated cases there are moments when the blood is not at all able to clot. In this case, everything ends with a fatal outcome, because there is no way to stop this process in any way.
In some cases, a coagulogram is also performed before surgery. Newborns also undergo surgery to remove certain pathologies. To date, the coagulogram is quite a common analysis, which is carried out when planning any surgical intervention. This will avoid all sorts of negative consequences during the ongoing "procedure".
Deciphering the coagulogram in children
The interpretation of the coagulogram in children does not differ much from the norms that are given for adults. Usually, after the analysis, all the obtained indicators are summarized in a table. Based on these data, it is possible to determine the presence of certain deviations. It is enough just to compare the obtained data with the norms. True, there are cases when it is difficult for doctors to understand the final result.
This may be due to the presence of pathologies, or other negative processes in the body. Basically, the standards fluctuate in the following ranges: APTT - 25-37 seconds; Fibrinogen - up to 6.5 g / l; Lupus anticoagulant - should be absent; Platelets - 131-402 thousand / μl; Prothrombin - 78-142%; Thrombin time - 18-25 s; D-dimer - 33-726 ng / ml; Antithrombin III - 70-115%.
There should be no other numbers. More precisely, they can be, but this indicates the presence of pathologies. The coagulogram shows the possibilities of blood, regarding the coagulation process and, in case of deviation from the norm, shows the presence of adverse processes in the body.
Coagulogram in myocardial infarction
Coagulogram in myocardial infarction is one of the most important tests. Thanks to him, you can determine the indicators of blood clotting. It is important in connection with the risk of developing DIC. It is characterized by leakage of blood through the vessels. This is considered one of the most severe complications of myocardial infarction.
This analysis must be carried out without fail. Based on the results, it is possible to determine deviations regarding blood clotting and draw certain conclusions. It is very important! Because a heart attack can give serious complications to the vessels.
It is difficult to say unequivocally what the indicators will be, in most cases it is purely individual. But any deviation of the "elements" indicates the presence of a pathology that must be fought. Any deviations are especially dangerous in the presence of problems with the cardiovascular system. The coagulogram may vary depending on what work is being done to correct problems with blood clotting.
Coagulogram indicators
Coagulogram indicators allow you to accurately evaluate the result. So, in order to decipher the results of the procedure, you need to know what indicators are included in it. So, these are APTT, Fibrinogen, Lupus Coagulant, Platelets, Prothrombin, TB, D-Dimer and Antithrombin III.
APTT is the time it takes for blood to clot. Any deviation from the fixed norm may indicate the development of complications. In some cases, this indicates disseminated intravascular coagulation.
Fibrinogen is a specific protein, which is based on a thrombus component formed during blood coagulation.
Lupus coagulant is a group of specific antibodies. A person should not have this indicator at all, but if it is still present, then there are problems in the body. It is likely that these are autoimmune diseases.
Platelets are blood cells that form in the bone marrow. If their rate is reduced, then the situation is in malnutrition or the presence of disseminated intravascular coagulation.
Prothrombin is a protein found in blood plasma. If necessary, it participates in the production of thrombin.
TV is thrombin time. During this period, fibrin is produced under the action of thrombin. The slightest deviation from the norm may indicate a pathology of the liver.
D-Dimer is an indicator that is fully responsible for the process of thrombosis. It plays a significant role in the timely detection of thrombosis. And finally, Antithrombin III is a protein that significantly slows down blood clotting.
All of these indicators are included in the analysis. The coagulogram allows you to determine which of them are normal, and if there are any deviations.
Norm of coagulogram
The norm of the coagulogram allows you to resort to many interventions, accompanied by minor blood loss. If the results of the analysis are within acceptable ranges, then this allows you not to risk during the operation or during childbirth.
Coagulability properties play a significant role. Especially if there is a serious “event” in the body. Only a doctor can decipher the results of the procedure. Many people try to understand on their own and from ignorance of the situation to the end they cannot realize whether their analyzes are normal or not.
It must be understood that the results may fluctuate in one direction or another. Normal indicators are characterized by: APTT - 25-37 seconds; Fibrinogen - up to 6.5 g / l; Lupus anticoagulant - should be absent; Platelets - 131-402 thousand / μl; Prothrombin - 78-142%; Thrombin time - 18-25 s; D-dimer - 33-726 ng / ml; Antithrombin III - 70-115%. If the resulting coagulogram shows far from such numbers, then there are serious deviations in the body that are worth fighting.
Tubes for coagulogram
Coagulogram tubes can be purchased separately or taken from the clinic itself. These auxiliary "means" serve to store blood.
They are glass or plastic flasks, inside of which the "raw materials" are located. In such a vacuum package, no extra elements will get into the blood. It is enough just to hand over the “raw materials” and place it in a test tube. The attending physician deals with this issue.
Test tubes can be different, made of different materials and different capacities. Therefore, it is better to purchase an "accessory" directly on the spot, so that in the future there will be no questions. A lot depends on what the blood is being donated for. It is not recommended to purchase test tubes on your own, it is advisable to consult a doctor and follow his wishes. A coagulogram is a procedure that requires correct conduct. That is why the first step is to visit the clinic, and then start preparing for the analysis itself.
Coagulogram - what is this analysis?
Many people are interested in a coagulogram, what kind of analysis is it and how to do it? It should be noted that this is a real way to determine blood clotting. Evaluation of the functioning of this ability today is very important. Especially if the patient has to lose some blood. In this case, we mean childbirth or surgery.
The study of coagulability is relevant during pregnancy, when problems with the liver, blood vessels and pathologies of the immune system are detected. Often this analysis is called a hemostasiogram. It includes several basic methods of implementation. Thanks to them, it becomes possible to determine the bleeding time, prothrombin time, thrombosed time, fibrinogen, lupus anticoagulant, D-dimer, antithrombin III and activated partial thromboplastin time (APTT).
All this is necessary to determine the main indicators and abilities of blood. This procedure is very important. Coagulogram helps to prevent possible negative outcomes.
Expanded coagulogram
What is an expanded coagulogram? This is a procedure by which it is possible to evaluate the functioning of the blood coagulation system. This is usually done for people suffering from strokes, heart attacks, oncology and other pathologies.
A detailed analysis is not done for women who are about to give birth soon. The detailed procedure includes APTT, INR, Prothrombin Time, Thrombin Time, Fibrinogen, Antithrombin III, Protein S, Protein C, D-Dimer, Willebrandt Factor and Lupus Anticoagulant.
All this allows you to thoroughly study the properties of blood clotting and understand whether a person can have a serious operation. Indeed, during such interventions, a large amount of blood is usually lost. If clotting is poor, then this significantly worsens the situation. There are also cases when the blood is not able to clot at all, this leads to death. Coagulogram allows you to fully assess the ability of the blood system.
Deciphering the coagulogram
Decoding of the coagulogram is carried out by the attending physician. It is not easy to understand what the analysis is about on your own. To do this, you need to have some knowledge about this topic.
So, as a result, the following indicators can be indicated: APTT, Fibrinogen, Lupus coagulant, Platelets, Prothrombin, TB, D-Dimer and Antithrombin III.
APTT is the time it takes for blood to clot. Any abnormalities may indicate the development of complications or disseminated intravascular coagulation.
Fibrinogen is a specific protein that is based on a thrombus component; it is formed during blood clotting.
Lupus coagulant is a group of specific antibodies. Normally, this indicator should not be at all, but if it is present, then most likely we are talking about autoimmune diseases.
Platelets are the blood cells of the blood, they are formed in the bone marrow. Their significant decline is usually caused by malnutrition.
Prothrombin is a protein found in blood plasma. It is from it that, if necessary, thrombin is produced.
TV is thrombin time. During this period, fibrin is produced under the action of thrombin. Any deviation from the norm can indicate liver pathology.
D-Dimer is an indicator that is responsible for the process of thrombosis. It is important for the timely detection of thrombosis.
Antithrombin III is a protein that slows down blood clotting.
For all these indicators, the analysis is deciphered. A coagulogram is a serious procedure for which you need to prepare.
What is included in the coagulogram?
Do you know what is included in the coagulogram? This analysis includes several main indicators, according to which it is determined by the presence of a deviation from the norm.
So, the usual coagulogram contains the following mandatory "elements": APTT, Fibrinogen, Lupus coagulant, Platelets, Prothrombin, TV, D-Dimer and Antithrombin III. If we are talking about a detailed analysis, then Prothrombin Time, Protein S, Protein C and Willebrand Factor are added to this list.
Each of the indicators is responsible for its "function". Due to deviations in one or another “element”, one can understand what problems exist in the human body. This is especially important before surgery or childbirth. After all, these two "activities" imply a slight loss of blood. The coagulogram, in turn, determines how quickly it can coagulate and whether there are any risks for a person. Therefore, this analysis should be treated with all responsibility.
INR
The INR coagulogram is a calculated indicator. It can be used to view the ratio of the patient's prothrombin time to the mean prothrombin time. Why is such an analysis carried out?
It is necessary to determine this indicator to control therapy with indirect anticoagulants. The last “elements” are drugs that contribute to poor clotting, these are warfarin and phenylin.
Patients on this therapy should monitor INR at least once every 3 months. Its excessive increase can lead to a tendency to constant bleeding. A decrease in INR indicates, on the contrary, an insufficient effect of anticoagulants. At the same time, there is a significant risk of thrombosis.
This indicator must be carefully monitored. A lot can depend on this criterion. The coagulogram of this indicator is not carried out so often and is included in an extended range of procedures, which is performed on special request.
APTT
The APTT coagulogram is the activated partial thromboplastin time. Simply put, this is the amount of time it takes for a blood clot to form after special reagents have been added to the plasma.
fibrinogen
PTI
PTI coagulogram is a prothrombin index. Under normal conditions, its value varies between 70-140%. This figure can significantly increase in pregnant women. But this is a negative phenomenon that occurs against the background of placental abruption. Naturally, this is a normal process, but it can happen in the early stages. This can lead to the loss of a child, so the level of IPT must be carefully monitored.
An increase in PTI directly indicates increased blood clotting. This process is observed in thrombosis and thrombophilia. In some cases, this phenomenon occurs after long-term use of oral contraceptives.
If this indicator significantly decreases, then this indicates that the person is prone to bleeding. Therefore, the issue of surgical intervention must be approached with particular seriousness. After all, the current situation can end badly. That is why a coagulogram is performed and all the necessary indicators are taken.
Dimer
RFMC
RFMK coagulogram is intended for quantitative determination of soluble complexes in blood plasma. This is how RFMK is deciphered.
Soluble complexes are markers of thrombinemia in intravascular coagulation. This indicator can be determined manually.
RFMK can not be attributed to the number of mandatory analyzes when conducting a coagulogram. Rather, it is carried out with an extended definition of an existing problem. Usually, it is determined during the upcoming surgical intervention.
The main indicator is taken from the donated blood. The person does not have to give anything extra. RFMK increases with the activation of blood clotting. Moreover, the higher the concentration of complexes, the higher the risk of intravascular thrombosis.
A decrease in the RFMC index is observed during treatment with heparin. This allows you to effectively identify patients who need heparin prophylaxis and heparin therapy. The coagulogram in this case thoroughly helps.
Prothrombin
Coagulogram prothrombin means blood clotting factor. This indicator is one of the most important. It is he who characterizes the state of the blood coagulation system.
Any change in its amount can lead to clotting disorders. This may lead to the impossibility of surgical intervention. After all, a person during this process can lose a large amount of blood.
Usually, an increase in prothrombin is observed with a tendency to thrombosis. Its normal value should not exceed 78-142%. A decrease in prothrombin is observed with a deficiency of vitamin K, as well as taking certain drugs, including warfarin and anabolic steroids. The level of blood clotting is determined quite simply. It is carried out on the basis of a general analysis - a coagulogram. It is one of the required indicators. Without these data, it is impossible to predict the course of surgery or childbirth in women. That is why the coagulogram is carried out immediately before the procedure itself.
Platelet aggregation
What is a coagulogram of platelet aggregation? First of all, it is worth noting the fact that platelets are the so-called ambulance of the body. As soon as the slightest damage to the vessel wall occurs, and blood begins to flow out, a biochemical reaction of platelets is instantly produced.
Once at the site of damage, the elements stick together and thereby stop the bleeding. Simply put, there is a blockage of the “impulse”. This process is called platelet aggregation.
This criterion is very important when performing surgery. After all, its direct losses depend on how quickly the blood can stop. A similar process occurs during childbirth. In some cases, platelet aggregation is slow and therefore the risk of any intervention remains. It is easier when this process, on the contrary, is accelerated, although this phenomenon is considered a pathology. In what "position" everything is, the coagulogram determines.
],Coagulogram table
The coagulogram table is the most convenient way to review the results of the analysis obtained. Usually, all data is summarized in a specific table, where they are compared with the norms.
As a result, all indicators should be described, depending on which analysis was carried out. With an ordinary coagulogram, the data of APTT, Fibrinogen, Lupus coagulant, Platelets, Prothrombin, TV, D-Dimer and Antithrombin III are entered in the table. With an extended definition, Prothrombin Time, Protein S, Protein C and Willebrand Factor are also added.
Usually, the table indicates the resulting indicator and the rate to which it should strive. In case of deviation, the reason for this phenomenon is described. After all, each indicator depends on its factors. Starting with the inflammatory process in the body and ending with pathological changes. Based on the data received, a decision is made regarding further actions. The coagulogram fully describes the state of blood clotting.
Before you go to take the analysis, you should consult with your doctor. He will make specific recommendations regarding the preparation process for the review. There is nothing complicated about this, you just have to give up food for 8-12 hours and not take certain medications. If you have any questions, please talk to your doctor. A coagulogram is carried out in compliance with all the necessary rules, this will allow you to get an accurate and reliable result.
How much is a coagulogram done?
Many people are interested in the question, how much is a coagulogram done? It should be noted that this is the age of advanced technologies, so you won't have to wait long. Blood is taken from a person and within an hour all the results are ready.
Naturally, a lot depends on the queue for this procedure. On average, you can find out your own indicators after one hour. True, today not always everything is carried out so quickly. Therefore, the maximum waiting time is one day. Usually, a coagulogram is carried out in the morning and at the same time the next day a person can get his results.
The very procedure of taking blood takes a matter of seconds and is nothing complicated or painful. If necessary, not only the analysis itself is carried out quickly, but also its results become available. Usually, a coagulogram does not require speed and is done exclusively before interventions that are accompanied by minor blood loss.
Coagulogram price
The price of a coagulogram directly depends on the country, city and the clinic itself. It is difficult to say exactly how much this procedure will result in. Basically, its cost does not exceed 100-250 hryvnia. Naturally, as mentioned above, it all depends on where it is held.
Modern clinics take the appropriate amount for the increased quality of work. Much depends on where the medical facility is located. If its location is closer to the capital, then the price will be appropriate. The further, the less, of course.
It should also be noted that auxiliary materials also play an important role. Among them are special test tubes. A person can purchase it both independently and use the services of a medical institution in which he is going to take an analysis. This also affects the price in some way. Therefore, if you are going to carry out this procedure, you should take 100-250 hryvnias with you. If we take into account the cities of the Russian Federation, then here a coagulogram costs an average of 1000 rubles.
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What it is? A coagulogram is a blood test to identify indicators of the hemostasis system, which determines the ability to coagulate and possible deviations.
Violations in the hemostatic process in the direction of increase or decrease lead to serious diseases, such as heart attack or stroke.
An increased level of hemostatic activity causes the formation of blood clots, and a lower level leads to bleeding. The analysis is usually performed together with a general laboratory blood test for nine points - a deviation in the indicators of each indicates a deterioration in the hemostatic functions of the body.
Coagulogram - basic concepts and definition
Hemostasis is a biological system whose work is aimed at maintaining the state of the blood, preventing damage to the vascular walls and dissolving blood clots that have performed their own functions. It includes three actions:
- First, when the endothelium is damaged or ruptured, a number of active substances are released. These are thrombomodulin, nitric oxide, prostacyclin, which triggers the primary defense mechanism.
- Second, platelet membranes rush to the area of damage to unite and close the gap.
- Thirdly, due to 15 plasma elements and enzymes (the so-called coagulation factors), a dense fibrin layer is formed that stops bleeding.
Along with clotting properties, the body has an anticoagulant mechanism. Both systems are in constant equilibrium. This circumstance determines the liquid form of blood, its necessary parameters and composition throughout the life of the organism, creating optimal conditions for it.
Violation of this balance is often not manifested outwardly. To identify it, a study of two types is performed (extended and conventional). If a pathology is detected during the basic analysis, an extended coagulogram is made.
This is due to the fact that all indicators are indicative. For a complete assessment, diagnostics is required for thirteen main points and a deviation from the norm in at least one column indicates the development of pathology.
Indications - why take a coagulogram?
When prescribing a study, patients have a question, what is a coagulogram for? The main reasons for conducting the analysis are the following factors:
- During planned surgical interventions, the risk of bleeding is taken into account. Before the operation, the doctor receives information about the state of blood coagulation.
- When hirudotherapy (the imposition of leeches), it is required to monitor hemostasis in order to prevent the risk of developing a hemorrhagic syndrome (damage to the vascular walls, impaired coagulation, changes in the number of platelets).
- When prescribing contraceptives, the analysis is carried out once every three months.
- During pregnancy, the study is done every trimester due to changes in hormonal levels.
- With autoimmune diseases.
- With pathologies of the liver.
- To select the optimal dosage of drugs based on acetylsalicylic acid.
- With diseases of the heart and blood vessels.
- With thrombophlebitis, embolism, varicose veins.
- With previously identified violations in hemostasis.
Coagulogram during pregnancy
The normal state of hematopoiesis is a paramount indicator of a healthy body of a future mother. Women during this period undergo changes as they prepare for an additional cycle of blood circulation and extravasation losses during childbirth.
The slightest violations in the indicators of coagulogram during pregnancy are recognized as a threat to the health of life for the mother and child. With an underestimated level of hemostasis, there is a risk of placental abruption and bleeding of a different origin and localization.
With an increased factor - the formation of blood clots and placental insufficiency. The latter causes a violation of the growth of the fetus and its hypoxia. Doctors also state cases of blockage of the vessels of the pulmonary artery and the occurrence of clots in the pelvic area and lower extremities, if there is a state of hypercoagulability.
Violation of clotting leads to premature birth or miscarriage.
A coagulogram is carried out as planned at the first visit to the gynecologist, in the second trimester (22-24 weeks) and the third (30-36). The frequency of the study increases in the following cases:
- Rh-conflict with the father of the unborn baby.
- predisposition to thromboembolism.
- Varicose veins.
- Vascular, endocrine, urogenital pathologies.
- Predisposition to increased coagulability.
- Problems with previous pregnancies (arbitrary termination, miscarriage).
- Changes in the state of the placenta.
- Diseases of the liver.
- Anemia.
- Development of several fruits at the same time.
- Autoimmune pathologies.
- Preeclampsia (manifested by increased pressure in the arterial system, protein in the urine and sometimes edema).
Each index is framed. For children, women and men, a standard analysis is traditionally prescribed.
Pregnant women and patients with the need to clarify the diagnosis are offered an extended examination.
Coagulogram interpretation and norms for adults (Table 1)
| Options | Name of indicator | Norm for adults | Norm for children |
| Clotting period | According to Lee White | 12-15 min. | 3-10 min |
| activated thromboplastin period | APTT | 25-35 sec. | 25-35 sec. |
| prothrombin time | PTV | 11-18 sec. |
|
| Prothrombin index | PI | 80-120% | 75-100% |
| D-dimer |
|
0.8 mg/l | |
| fibrinogen | 2-4 g/l | 2.70-3.60 g/l | |
| Antithrombin | 70-120% | 70-120% | |
| Concentration of soluble complexes | RFMC | 3.35-4.0 mg/100 ml plasma | 3.0-3.5 mg/100 ml plasma |
| Lupus anticoagulant | 0 | 0 |
Coagulogram interpretation (standard and extended)
The coagulogram includes a fixed number of indicators. Each of them displays the functions of blood coagulation. In practice, a standard study is required. The doctor selects the parameters necessary to confirm the diagnosis.
These are typical mechanisms for ordinary situations. If, with such an analysis (coagulogram), the decoding shows deviations, additional extended studies are assigned.
Each indicator provides the following information.
1. Fibrinogen.
This is an enzyme produced by the liver. It reacts to inflammatory and necrotic processes, infections occurring in the body. When reagents are added, the substance turns into fibrin. The fibers are placed on a filter device, dyed and weighed, so the unit is g/l.
During pregnancy, the indicator rises, reaching a value of 6 g / l, which is not considered a deviation. In other cases, an increase in the level of the enzyme may indicate the development of the following pathologies:
- Heart attack.
- Trauma and burns.
- Rheumatism.
- Atherosclerosis.
- malignant formations.
- postoperative conditions.
- nephrotic manifestations.
- Myelomas.
Indicates the following diseases:
- Heart failure.
- Genetic enzyme deficiency.
- Cirrhosis.
- Taking drugs that eliminate blood clots.
- Mononucleosis of infectious etiology.
- Food or chemical poisoning.
- The development of the metastatic process in oncological diseases.
- Complications after childbirth.
- late toxicosis.
- Leukemia (a group of oncological diseases of the blood system).
2. APTT
Partially activated thromboplastin time is a parameter showing the interval at which one clot is formed. The value reflects the rate of the first phase of coagulation.
This is a sensitive and accurate indicator that determines the norm in women in the blood with the help of a coagulogram. The values depend on the reagents and may vary in each laboratory.
Therefore, the analysis form always contains reference values developed in a particular laboratory. An increased parameter shows the following problems in the body:
- Deficiency of clotting factors.
- Disseminated intravascular syndrome in the second and third phases.
- Taking heparin drugs.
- Autoimmune pathologies.
- Hemophilia.
- Antiphospholipid deficiency (a syndrome in which damage occurs to phospholipids located on the cell membrane).
- thrombophilia.
- Parenteral administration of hydroxyethylated starches.
The short index defines the following pathologies:
- Thromboembolism.
- Pregnancy.
3. PTV
It characterizes hemostasis and the ability to coagulate. The index determines the period of creation of clots with calcium and the plate.
The study is carried out to evaluate the external clotting pathway. The interpretation of the results implies violations or complications in the body with a shortened indicator:
- Taking oral contraceptives.
- Disseminated intravascular syndrome.
- The last weeks of pregnancy (the body is “preparing” to stop blood loss during childbirth).
The lengthened factor is interpreted as follows:
- Diseases of the liver and biliary tract.
- Therapy with anticoagulants of indirect action.
Thrombin time determines the final stage of blood clotting. In this interval, fibrinogen is converted to fibrin by the action of enzymes.
It is determined simultaneously with APTT and PTT for the diagnosis of congenital pathologies and the assessment of anticoagulant functionality. An underestimated indicator indicates heparin and antifibrin therapy.
Deviations in the long side (reduced clotting) indicate the following diseases:
- lack of fibrinogen.
- Increased amount of bilirubin.
- The presence of structurally abnormal protein elements in the blood.
- Chronic pathologies of the liver.
- Myeloma.
The parameters discussed above are detected with a standard coagulogram. When the indicators change in one direction or another, additional studies are assigned (included in the extended coagulogram):
- Antithrombin is a factor that prevents the pathological formation of clots.
- The prothrombin coefficient indicates the ratio of the PTT of a particular patient to the corresponding standardized indicator in the international susceptibility index. This is the correction value needed to compare the results obtained in research centers independent of each other. The main purpose of the analysis is to control the intake of indirect coagulants by patients.
- RFMK - index of intravascular coagulability.
- The D-dimer coagulogram shows the amount of products formed during the breakdown of fibrin after the destruction of a thrombus. The analysis is required for the diagnosis of early thrombosis. Often it is prescribed in obstetric practice, especially with repeated pregnancy losses.
- Lupus anticoagulant is aimed at diagnosing antiphospholipid syndrome. Normally, the amount of enzymes is minimized or not detected at all. An increased index indicates a threat of miscarriage and a predisposition to the occurrence of blood clots in the arteries and veins.
How to take a coagulogram?
The results of the study largely depend on the preparatory stage. Blood is taken from a vein. The procedure is carried out a few hours after eating. The last meal - eight hours before the start of manipulation. Drinking water is allowed during prohibited times.
If a person is undergoing treatment that involves taking drugs that can affect clotting, the doctor is warned in advance. Otherwise, the diagnostics will show an unreliable result.
It is forbidden to take alcohol, drink tea, coffee and juices. One day before the analysis, you must stop smoking.
Muscle strain, anxiety, stressful conditions affect the performance and interpretation. The procedure is painless, short-term, it is recommended to remain calm during the sampling.
- The results of standard studies are ready in a day.
- It takes 3-4 days to decipher an extended coagulogram.
Our organism protect numerous mechanisms that ensure homeostasis - the constant constancy of the internal environment of our body. One of the most important of them is the system of hemostasis or coagulation, which prevents blood loss when the integrity of the bloodstream is damaged. In the process of blood clotting and clot formation, there are dozens of reactions that can be influenced by hundreds of different chemicals. And in itself, this system includes a number of other regulatory mechanisms, some of which increase blood clotting, while others lower it.
Due to the great importance of the system hemostasis For the stable functioning of the body, various methods have been developed in clinical medicine to study this protective reaction of the body. The most common analysis for the study of blood clotting is the determination of the coagulogram, which includes determining the time required to stop bleeding and the number of various factors of this system. This study provides a lot of information about the state of the body as a whole, because the normal operation of the hemostasis system depends on the proper functioning of various organs and systems, so any disturbances in their work are reflected in the coagulogram.
There are a number testimony that warrant this study. Firstly, the determination is mandatory before surgical interventions - during operations, the integrity of the bloodstream is significantly violated, which must be eliminated by the hemostasis system. Otherwise, severe complications may develop in the postoperative period. Secondly, this analysis is often prescribed for pregnant women - due to strong hormonal changes, various blood clotting disorders are possible, both in the direction of its decrease and increase. Thirdly, the determination of the coagulogram is desirable for diseases of various organs that are somehow related to the process of blood clotting - first of all, these are the liver, spleen, bone marrow, and the cardiovascular system. Also, autoimmune diseases have their influence on the formation of blood clots. Finally, determining the activity of the blood coagulation system is useful and, in some cases, necessary before prescribing certain drugs - anticoagulants (for example, heparin), acetylsalicylic acid, hormonal contraceptives.
Donating blood for determination activity of the coagulation system requires some preparation. 8-12 hours before the study, you should not take food, alcoholic beverages, coffee or strong tea. Some of the parameters of the coagulogram have a certain instability, especially in stressful conditions for the body, therefore, before and during the test, one should not be nervous or subjected to heavy physical exertion. Immediately before blood sampling, a person is given a glass of clean water to drink - this increases the accuracy of the study. Blood is taken from a vein in the arm and immediately begin to determine the main indicators.
Exists basic and detailed blood test to determine the coagulogram. The norm of the basic coagulogram looks something like this:
Despite such a large number indicators, usually the form of the basic coagulogram contains only the main ones - fibrinogen concentration, clotting time, activated recalcification time (AVR), activated partial thromboplastin time (APTT), prothrombin index, thrombin time, the amount of soluble fibrin-monomeric complexes. Based on these values, one can indirectly determine the activity of a particular factor.
clotting time- one of the basic indicators, which is determined by one of the first. Its value depends on the type of material of the test tube in which the indicator is determined. In a glass container, the formation of a blood clot normally takes from 5 to 7 minutes, while in a silicone tube, the normal clotting time is 12-25 minutes. Due to such a large difference between the two norms of this indicator, depending on the material of the container, it is necessary to specify in the analysis form whether a silicone or non-silicone tube was used for this. The lengthening of this indicator indicates a decrease in the activity of the hemostasis system or an increase in the thrombolytic ability of the blood, and a more rapid formation of a blood clot indicates the opposite phenomenon - an increase in the activity of blood coagulation, or a decrease in the antithrombin system. The causes of these phenomena are determined by other indicators of the coagulogram.
fibrinogen concentration- one of the main proteins of the hemostasis system - is also a key indicator of the coagulogram. It is this soluble protein that, during the formation of a blood clot, turns into strands of insoluble fibrin, which forms a thrombus. The norm of its content is 2-4 g / l of blood plasma, which is a fairly high indicator. It is characteristic that in pregnant women on the eve of childbirth (in the third trimester), there is an increase in the content of fibrinogen up to 6 g / l, which is a normal preparation of the body for bleeding that accompanies the birth of a child. However, you should carefully monitor this indicator - its excessive increase can cause blood clotting right inside the bloodstream, which underlies the onset of DIC, often leading to death. In addition to pregnancy, the level of fibrinogen increases with various inflammatory processes, shocks of various origins, and endocrine disorders.
Decrease in this indicator coagulograms causes increased bleeding and an increase in blood clotting time. The cause of this condition may be some liver diseases (hepatitis, cirrhosis), lack of vitamins (K, C, B) and related diseases of the gastrointestinal tract (dysbacteriosis, Crohn's disease, malabsorption syndrome), taking certain drugs, as well as the second stage of DIC.
Activated Recalcification Time (ART) in a coagulogram, it characterizes how quickly the level of calcium ions (which are involved in the formation of a blood clot) in the blood plasma is restored. The normal phenomenon is the value of this indicator in the range from 1 to 2 minutes (60-120 seconds). An increase in the duration of recalcification indicates a reduced blood coagulation activity, which is a consequence of an insufficient number of platelets in the blood or their functional inferiority, a lack of the main factors of the hemostasis system, an increased activity of the antithrombin system, and also in the second stage of DIC, when there is an exhaustion of the entire blood coagulation system .
Decreasing time recalcification speaks of increased thrombosis - with thrombophlebitis and thrombosis.
Activated partial thromboplastin time (APTT)- characterizes the time it takes for the formation of a blood clot. The norm of this parameter of the coagulogram is 35-45 seconds, but when using some types of reagents, 28-35 seconds can also be considered the norm. A shortening of this time is not a characteristic clinical sign of any disorders, but a significant increase occurs with the use of anticoagulants (heparin), an acquired or congenital deficiency of the main blood coagulation factors (for example, hemophilia), with some autoimmune diseases (systemic lupus erythematosus).
Prothrombin index- the ratio of human plasma time to the reference value. This indicator of the coagulogram is expressed as a percentage and is normally 78-142%. The prothrombin index is the most accurate value that determines the efficiency of the entire hemostasis system. A decrease in this indicator is a sign of low blood clotting, which occurs as a result of a lack of key factors, vitamin K deficiency, diseases of the liver and gastrointestinal tract. An increase in the protombin index indicates a high risk of thrombosis and related disorders - myocardial infarction, stroke, kidney damage, thromboembolism of various vessels.
thrombin time- an indicator closely related to the level of fibrinogen in the blood. Physically, it represents the time during which a certain amount of fibrinogen passes into insoluble fibrin - the norm is from 10 to 20 seconds. With an increase in this time, a decrease in the level of fibrinogen is observed, or this phenomenon is due to the activity of fibrinolytic systems and factors - for example, in liver diseases, pancreatitis. Also, an increase in thrombin time occurs with the use of anticoagulants. A decrease in this indicator of the coagulogram is observed in the last trimester of pregnancy and other factors leading to an increase in the level of fibrinogen in the blood.
The amount of soluble fibrin-monomeric complexes- these proteins are a transitional link between fibrinogen and fibrin. The norm of their content in blood plasma is 3.36-4.0 mg per 100 ml of plasma. An increase in the number of these complexes indicates an increased activity of the hemostasis system. A decrease in this indicator is observed with a general decrease in the activity of the blood coagulation system. This indicator is the first to respond to the use of anticoagulants, therefore it is the most accurate and sensitive method for determining the effectiveness of anticoagulant therapy, which is widely used in clinical practice.
Typically, after analysis an extended study is performed to compile a basic coagulogram, which is used to confirm problems with blood clotting. The purpose of obtaining an extended coagulogram is to more accurately determine the causes of certain blood clotting disorders. As part of the extended analysis, a number of additional indicators are determined.
Protein C is one of the most important anticoagulant factors. Its level is expressed as a percentage of the reference indicator, the norm of determination in the extended coagulogram is 60-140%. With a decrease in this indicator, the blood coagulation system begins to prevail, which leads to increased thrombosis. The reason for the decrease may be liver disease and vitamin K deficiency, which often develops as a result of colon dysbacteriosis. Also, a decrease in the level of protein C may be due to genetic factors.
D-dimer is a product of partial disintegration of a fibrin clot (thrombus), therefore, with increased thrombus formation, the level of this indicator also increases. The content norm - its amount should not exceed 500 ng / l. In pregnant women in the last trimester, due to a general increase in the activity of the hemostasis system, the level of D-dimers may slightly exceed the norm. In other cases, a significant increase in this indicator is a symptom of thrombophlebitis, disorders in decompensated diabetes mellitus, and toxicosis.
Antithrombin-3, as well as protein C, is an anticoagulant factor, the norm of which is from 75 to 110% of the reference value. A sharp decrease in the content of this factor plays a special role, since in such a situation the risk of thrombosis with the development of an embolism or even DIC increases significantly.
Antibodies to phospholipids also called lupus antibodies, are normally completely absent in the blood. Their appearance in plasma is a sign of systemic lupus erythematosus, a severe autoimmune disease. The determination of their content in plasma within the framework of an extended coagulogram is due to the fact that this type of antibody destroys platelets and thereby sharply reduces blood clotting.
Level platelets when determining the coagulogram, it is rarely determined, since often this value is already known from the general blood test. However, the role of platelets, the norm of which is 180-320 billion per liter, in the development of a blood clot is enormous, so it makes no sense to start any research without first determining their number.
