Analysis of blood coagulation. What do you call that dealt with the pregnancy of the finger veins. Price Invitro, Hemotest

The circulatory system is responsible not only for the power and gas exchange in the bodies, but also has a protective function. In the preparation of various blood cells injuries form clots which block blood vessels damaged by stopping its loss. This process is called coagulation. Monitor the status of such a protection system by analyzing clotting.

What is a blood clotting

Coagulation - is one of the stages of hemostasis, which is responsible for the preservation of the necessary for the functioning of the body's blood viscosity, that is, the system prevents bleeding.

The protective function is performed in 2 stages:

1. Vascular-platelet hemostasis. When integrity is disrupted tissues, blood vessels constrict, and place their walls closes damage blood cells - platelets. This process avoids the blood out of the blood vessels. The duration of the first stage does not exceed 3 min.
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2. hemostasis coagulation. The body produces a special protein cells - fibrin. They have a special thread-like appendages that allow them to be fastened to each other to form long polymer chains. Such protein called thrombus formation. They make the blood more viscous, preventing the penetration of foreign agents in its flow.

This biochemical process takes place only locally. While eliminating the threat of liquid bleeding becomes fluid again.

For the normal functioning of all systems of the body the blood must always contain a certain degree of viscosity. coagulation process is responsible for its balance. When hemostasis disturbances may cause heavy bleeding or blood clots. Both states are a threat to human life.

Why conduct research on blood coagulation

Since any pathological condition and blood thinners folding system leads to death of the patient, making coagulation is necessary for each person.

In addition to the usual clinical examination, coagulation analysis is indicated for:

• varicose veins;
• blood diseases;
• autoimmune diseases;
• suspicion of hemophilia;
• heart disease;
• toxicosis in the later stages;
• heart attack;
• stroke;
• reducing immunity;
• treatment of blood thinners;
• hormone replacement therapy;
• pathologies of the bone marrow;
• beriberi;
• pulmonary embolism;
• liver diseases;
• thrombosis large veins;
• disorders of blood flow in the pelvic organs;
• scleroderma;
• diabetes;
• rheumatoid arthritis.

Any of these conditions is dangerous bleeding opening which, when failure of hemostasis is difficult to stop. And also carries the danger of increased blood viscosity, since the risk of getting clots increases in heart muscle, causing its rupture or blockage.

When and who appoints the study

Analysis of blood clotting is called coagulation. There is also a hemostasiogram, which in addition to the basic indicators of the hemostatic system and shows the state of coagulated blood. One of the tests carried out depending on the presence of symptoms.

Blood tests may appoint several doctors:

• therapist with complaints of non-healing wounds and abrasions;
• A surgeon and anesthesiologist during preparation and after operation;
• obstetrician before delivery;
• a reproductive geneticist at pregnancy planning;
• immunologist suspected von Willebrand disease or DIC;
• neonatologist at the initial examination of the newborn;
• dentist before microoperations in the oral cavity.

To conduct a survey in these cases, it is imperative to avoid serious consequences after manipulations. Also, a blood test performed after surgery, since it requires control of wound healing and tissue fusion.

How to prepare for the study

Blood - it is an unstable liquid. Her condition and the structure is constantly changing. For correct and accurate results, special training should be carried out.

It is enough to observe a number of rules:

• do not eat food for 12 hours prior to analysis;
• with a keen sense of hunger can drink some clean water - no more than 0.5 cups;
• per day is necessary to give up soft drinks;
• a few days do not eat smoked, fried and salty foods;
• It prohibited the use of alcohol-containing beverages for at least 3 days prior to the survey;
• before collecting biological material is not allowed to smoke;
• Nightly avoid any excessive physical activity.

If you need to donate blood for children, it is recommended to follow one rule:

• infants: the last 40 minutes before feeding. before blood sampling;
• up to 5 years: meal should be 4 hours prior to analysis.

How and who is conducting a study

Analysis of blood clotting is also called Hemotest, but more often the wording used in specialized laboratories.

The best of them are:

The name of the clinic	price, rub.
Helix	From 200 to 1650
Invitro	1310 to 3470
Hemotest	from 1720
MedExpert	from 1100

Price coagulation depends on the type of analysis and the number of indicators in it.

blood coagulation inspection is carried out in the morning. Biomaterial laboratorian collected from a vein using conventional syringe or vacuum. For analysis requires about 20 ml of liquid, so it is placed in a few special tubes treated with sodium citrate. In the laboratory, the blood is checked by several parameters in different ways.

Some methods require delivery of capillary blood, then the laboratory is gaining a small amount of biological material from a finger stick.

• The clotting time.

This parameter is determined different ways:

1. According Morawica: a drop of the test liquid is placed on a transparent glass, and carry out a special sterile spatula. Intersect time from blood contact with the glass surface prior to the formation of protein filaments, i.e. to the biomass seal. Norm believe coagulation for 4-6 minutes. For analysis using capillary blood.
2. According to Mas-Magro: glass, treated with paraffin and Vaseline, dripping blood, then it is collected with a pipette or dispenser, this step is performed until until a clot. Stopwatch intersect the time from droplet deposition on the surface prior to sealing mass. For analysis using capillary blood.
3. According to the Sukharev: the capillary gaining about 25 ml of blood, it was distilled in a central portion. Every 30 seconds. tilt tube. It notes the time since the liquid into the capillary prior to the termination of its transfusion on it. The average norm of this method - 2-5 minutes. Blood for the study are drawn from the finger.
4. Lee-White: 3 tubes were placed on 1 ml of blood. At a temperature of 37 ° C forms the prothrombinase blood which triggers coagulation. Timed time from blood entering the tube to cease its outflow of inclined tubes. This method can use any type of blood.

Lee-White method is the basis for determining the clotting time. Most laboratories use modern hemostasis analyzer, which records the clotting time.

• Thrombin time.

The plasma of venous blood was partitioned in several test tubes, put them into the optical analyzer at 37 ° C. In each sample is added to calcium chloride, and the time of fibrin formation.

• Prothrombin time.

In this study involved only venous blood plasma. The biomaterial is placed in a test tube with sodium citrate. It binds calcium particles in the fluid, slowing clotting.

With the plasma separated by centrifugation of the total weight. Then, by automatic devices, it is heated to 37 ° C and poured into a mixture of calcium-thromboplastin. After neutralization with sodium citrate was added to a sample of clotting factor III and the coagulation time is fixed. It is measured automatically using a built-in optical sensors.

In determining this parameter is often used mechanical method, since the instrument may issue erroneous data due to the presence in the blood of fat cells or elevated bilirubin content therein.

• Activated partial thromboplastin time (APTT).

In human blood should be several coagulation factors. This parameter specifies which enzymes are not enough for normal hemostasis. To the blood from the vein added phospholipids which stimulate platelets compacted. The parameter is determined only by means of automatic devices.

• Prothrombin index.

It is calculated as the ratio of the patient's blood clotting time to the average normal.

• Fibrinogen.

The concentration of the clotting factor is determined on automatic or mechanical analyzer according to Clauss method. Venous blood plasma is diluted with a buffer solution in a ratio of 1: 9 was added to a mixture of thrombin. With the optical sensors fixed clotting time. Then, the fibrinogen concentration was calculated by a calibration curve previously constructed.

• The platelet count.

Counting of blood cells is carried out in two ways:

1. mechanical: Pap 1000 erythrocytes. Using a microscope all platelets considered between these cells. Further, the calculation is carried out according to formulas based on the number of red blood cells.
2. automatic: count cell concentration is conducted on a hematology analyzer.

For analysis requires capillary blood.

• The duration of bleeding by Duke.

Using a special needle making a puncture in the earlobe or the ring finger depth of 4 mm. Then every 10 seconds. applied to the puncture site filter paper. Time is marked with the appearance of the first drop to the termination of the appearance of traces of blood on the filter.

Norms of blood clotting

Analysis of blood clotting is also called "factorial". Indicators, which go beyond the normal range, indicate the lack of one of the 13 plasma coagulation factors. Violation of their quantitative relationship increases the risk of diseases of the cardiovascular system.

Key indicators of blood coagulation:

Parameter	normal values
The clotting time (Lee-White)	2-6 min.
thrombin time	12-25 seconds.
prothrombin time	Adults: 11-18 seconds, newborns: 13-17 sec.
prothrombin index	80-115 %
platelets	Age	Women, g / l	Men, g / l
2 weeks	143-450	216-420
4 weeks	278-570	245-586
9 weeks	330-597	230-565
6 months	245-580	240-530
2 years	215-460	205-445
6 years	188-395	200-402
From 6 years and adults	150-400
Activated partial thromboplastin time	32-50 seconds.
fibrinogen	Adults: 2-4 g / l, newborns: 1,25-3,0 g / l.
The duration of bleeding by Duke	2-4 min.

That may influence the outcome

Regardless of the method of blood tests, the result may be wrong or inaccurate.

Distort the values ​​obtained are:

• lack of hygiene and technology at a fence material;
• improper storage of the blood before the study;
• continuous transport of blood;
• entering the sample of fat cells;
• recent blood transfusions;
• Venous blood entering the capillary;
• alcohol or too fatty foods;
• taking certain medications:
• antibiotics;
• steroid agents;
• diuretics;
• inhibitors;
• anticoagulants;
• Vitamin K;
• hormonal agents;
• vomiting;
• diarrhea;
• unhealthy diet with a predominance of protein and carbohydrate products;
• uncontrolled consumption of sugar;
• pesticide poisoning;
• lack of vitamin B group;
• stress;
• period of gestation;
• the use of insufficient quantities of water;
• biomaterial fence in the afternoon or evening;
• previous myocardial painful shock.

Decoding results

The resulting data should be decoded only by a physician. Depending on the results of the study drawn up clinical history and makes the blood correction circuit or additional examinations if necessary.

1. coagulation time.

Analysis of blood coagulation has the same name as its basic parameter. clotting time is mainly due to the possibility of a quick time without any additional studies. But the temporary measure is considered preliminary, and rapid test is conducted in the case of serious illness.

Increased clotting time indicates the development of:

• hemophilia;
• hepatitis A;
• cirrhosis.

Lower values ​​indicate:

• malfunctions of the endocrine system;
• bleeding.

Also, values ​​below normal levels may occur when taking hormonal agents and after surgery. After birth, the small figures are the norm, but require control for several days.

2. Thrombin time.

This parameter determines the occurrence of coagulation. At this stage of fibrinogen formed a fibrin. The most important test is active in the control and treatment of fibrinolytic drugs heparin and in the presence of genetic abnormalities of the hemopoietic system.

Explanation of this parameter is carried out together with the result of the activated partial thromboplastin time and protrombirovannogo.

Increase value when:

• the absence of the formation of fibrin;
• acute phase of DIC;
• myeloma;
• increasing the concentration of bilirubin;
• autoimmune diseases;
• poisoning;
• cirrhosis;
• renal insufficiency.

Reducing index shows the initial stage of DIC.

3. Prothrombin time.

This parameter evaluates the concentration of clotting factors in the plasma, i.e. the first phase flowing hemostasis.

Increased time takes place at:

• liver diseases;
• lupus;
• pathologies of the bile ducts;
• plasma transfusions;
• heparin therapy.

Decrease parameter indicates:

• the development of DIC;
• approximation of delivery time;
• receiving hormonal agents and preparations containing protrombirovannye clotting factor.

4. Prothrombin index.

This design parameter is standardized. It is necessary to assess the effectiveness of anticoagulant therapy. The increase in values ​​in patients receiving coumarin preparations indicates a reduction in the risk of blood clots without strong blood thinners.

But if at the same time an indicator of increased and prothrombin time, it indicates the presence of:

• chronic hepatitis;
• protein metabolism disorders;
• cirrhosis;
• DIC;
• vitamin K deficiency;
• genetic pathologies of blood coagulation;
• insufficient production of fibrinogen;
• biliary spasms.

Lower values ​​indicate:

• thromboembolism;
• thrombosis;
• pregnancy;
• violation of the plasma composition.

5. Platelets.

This indicator monitors the composition of the blood and hematopoietic system diseases. Increasing the number of these cells is associated with hormonal drugs or of an earlier operation.

Lowering the concentration of blood cells suggests the development of:

• blood cancer;
• spinal pathologies;
• liver disease;
• thrombocytopenia.

6. Activated partial thromboplastin time.

Analysis of the blood clotting activity includes the study of all coagulation factors. This parameter is briefly called APTT. He is the most sensitive to the occurrence of abnormalities in the body.

Exceeding the normal range indicates:

• resorption of blood clots;
• hemophilia;
• lack of 2, 5, 8-10, 12 and clotting factors;
• autoimmune diseases;
• DIC;
• cirrhosis of the liver;
• Hageman's disease;
• hepatitis.

Reducing the APTT is normal during pregnancy, as well as evidence of:

• initial stages of DIC;
• appearance of malignancies;
• internal bleeding.

7. Fibrinogen.

The amount of this protein describes the process of the last stage of hemostasis.

fibrinogen concentration increases with:

• inflammations;
• trauma-informed;
• appears in the body of viruses;
• the development of cardiovascular pathologies;
• menstruation and harboring;
• autoimmune pathologies;
• nephritis;
• amyloidosis;
• extensive burns;
• pyelonephritis.

Reducing the protein level indicates:

• cirrhosis of the liver;
• leukemia;
• genetic lack of fibrinogen;
• genital cancers;
• acute phase of DIC;
• poisoning;
• mononucleosis.

8. The duration of the bleeding.

This test helps to quickly identify the pathology of the hemostasis system.

Growth time period may indicate the presence of:

• cirrhosis;
• hemophilia;
• hemorrhagic fever;
• thrombocytopenia;
• gepatoza;
• hepatitis A.

The result is lower than the norm is considered wrong and requires re-survey.

What if the detected abnormality

Upon receipt of the results, which were found deviations from the normal values, it is necessary to address urgently to the therapist or a hematologist. It is impossible to independently interpret the results, as many of the parameters are considered only in conjunction with others, and do not indicate a serious deviation.

After reviewing all the indicators, the doctor can determine the presence or absence of pathology, as well as their degree. If at the time of the study, patients taking medications must notify the doctor, since some significantly distort the results.

As they are influenced by:

• menstrual cycle;
• age;
• food;
• bad habits;
• pregnancy.

Most often, abnormalities caused by dehydration or infection. If necessary, the doctor will prescribe additional tests and special drinking regime.

When detection via analysis in hemostasis disorders may require treatment with:

1. Kontrikala and hemostatic agents that increase the levels of fibrinogen;
2. Vitamin K;
3. transfusion of donor blood, which increases the level of fibrin;
4. Vikasola, which is an indirect coagulant, magnifying factor of the blood;
5. Oprelvekina and hydroxyurea which control the concentration of platelets;
6. Protamine, which eliminates the effects of heparin therapy;
7. Cryoprecipitate, which treats hemophilia and von Willebrand disease.

These funds are administered only under the supervision of specialists in the hospital.

it is recommended to increase the intake to enhance the therapeutic effect:

• folic acid;
• cottage cheese;
• milk;
• cheese;
• yogurt;
• fish;
• red meat;
• green;
• legumes and cereals.

Control of the hemostatic and hematopoietic system is possible only if the periodic study of blood clotting. When deviations are detected primary doctor may prescribe a more extensive examination of a biological fluid, which is called an extended coagulogram. Timely submission of these analyzes allows you to save not only the health but also human life.

Author: Anna Shalunova

Registration of the article: Mila Friedan

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