Coagulation. What kind of analysis, decoding, in the blood of adult rate. Table. Why take a pregnancy, before surgery, how do Hemotest how many days

Coagulation - This analysis, which assesses the performance of the biological systems of the body responsible for ensuring that the blood thickens.

Coagulation: what kind of analysis?

Comprehensive blood analysis, which allows to evaluate the work of the hemostatic system and all its disorders called coagulation. The analysis is required in order to be able to timely prevent symptoms of bleeding or thrombotic thrombocytopenia contrary (lack of platelet production).

Kinds

Coagulation (this analysis steps biological system of the body) - a comprehensive examination that includes the following indicators:

1. APTT - a temporary determiner formation of a blood seal (thrombus), after the liquid portion of blood to the added chemical product - calcium salt of hydrochloric acid. The test is considered infallible. With this method, check the phase of the hemostasis, which is responsible for stopping bleeding, and are judged on the internal state of the coagulation pathway.
2. The main plasma protein factor - Antithrombin III. This glycoprotein, which is summarized in the inner lining of blood vessels and cells in the body's largest gland Human - liver. It manifests itself for depressing the formation of dense blood clots.
3. Colorless protein - fibrinogen. During the formation of blood clots amplification system cleaved by thrombin reaction base catalyst. Wherein fibrinogen is converted to fibrin, which is the essence of the dense clot.
4. PTI - the ratio of time the appearance of a dense clot in the standard liquid to a patient's biological fluid taken.
5. Prothrombin hour. Temporary measure conversion of fibrinogen to fibrin - dense clot. The test substances are involved: calcium ions and protein-lipid complex.
6. TV - thrombin time conversion. In this process, the clot is formed, when joining the biological fluid serine protease. This test assesses the violation of the hemostasis.

testimony

Among the many symptoms to conduct coagulation test is the main purpose, which should include:

• Quality inspection of the system responsible for blood clotting;
• hereditary chronic bleeding;
• decrease of platelets in the plasma;
• hypercoagulation;
• the risk of stray thrombus;
• phlebeurysm;
• abnormal narrowing of the arteries of the lower extremities;
• rest angina;
• long flowing pathological lesion vessels of the legs due to blockage of the lumen of the circulatory system atherosclerotic plaques;
• myocardial infarction;
• deep vein thrombosis;
• during the preparatory period before surgery;
• ischemic stroke;
• autoimmune diseases;
• consumption coagulopathy.

How to prepare for analysis

To get the correct test result should follow certain principles:

• eat food should be not later than 8 pm;
• should drink water;
• You can not drink caffeinated beverages, as well as juices, sodas and any kind of alcohol;
• should not smoke prior to analysis turn, for at least 120 minutes;
• Avoid psycho-emotional stress;
• excluding the use of all kinds of drugs before analysis turn (except for systemic hormonal therapy and insulin, as it should be said medical technician);
• strong physical exertion in sport or hard work - to limit the 24 hours before taking the test;
• not to do the test in the days of menstruation;
• prior to analysis should have a good rest and sleep.

How is the analysis

Coagulation - This analysis, which should be done according to certain rules, and they must comply with health professionals:

• blood test must be taken from a vein, which is not done in the near future injection;
• necessary to use large-diameter needles;
• using no vacuum filler with a test tube - must carefully pour blood into the container for storage and transport, without the formation of foam;
• to calculate the rate of formation of clots, the blood was placed in a vessel without the addition of chemicals;
• in the biological fluid to all the other forms of coagulation to be added a certain amount of anticoagulant and mix gently;
• in the future, using the "centrifuge" unit, a liquid portion of the blood.

How to wait for results?

To calculate the necessary parameters in coagulogram, need 24 hours. But it all depends on the test taking place, the location of the laboratory, equipment, holidays. response time can last up to 4-5 days.

Decoding performance

Coagulation - This analysis of the results which the doctor, order tests, can make a lot of conclusions:

• is it possible to do the operation (determination of platelet adhesion);
• an increased risk of blood clots;
• determination of many infectious disease states in the body affects the amount of dimer;
• the risk of not ischemic events;
• bleeding tendency;
• abnormal increase in blood clotting;
• autoimmune disease;
• education in the capillaries and arterioles of blood clots;
• thrombocytopenia;
• liver disease.

APTT

Hemostasiogram - this is a test consisting of a series of surveys. APTT - factor responsible for the duration of thrombus formation after adding to patient biological liquid calcium salt of hydrochloric acid.

In the process of counting and the coefficient test result evaluation is necessary to pay attention to certain points:

• the number of years the patient (in children the length of clot formation long, and in older patients the opposite - shorter);
• systemic administration of the heparin preparation;
• use of drugs that disrupt the formation of prothrombin in liver cells;
• should pay attention to the number of red blood cells;
• the correct ratio of blood and chemicals.

The reference to the normal indicators should include 22,5-31,7 seconds.

Lengthening test Indicator time possible under the following disease states:

• lack of protein serine proteases;
• proteins lack the group responsible for the stability of blood pressure, blood clotting, and pain threshold;
• Hereditary hemorrhagic diathesis;
• pathological development of antibodies to phospholipids;
• systemic heparin therapy;
• lack of fibrinogen in the blood;
• pathology gepatobilliarnoy system;
• thrombus formation in small vessels system;
• blood transfusion;
• long flowing glomerular nephritis;
• autoimmune pathologies.

Shortening the time APTT:

• an increased risk of blood clots;
• the formation of secondary cancer cells;
• hemorrhagic shock;
• appearance of a large amount of active thromboplastin lesions start as a consequence of the system of capillaries and arterioles;
• well flowing pregnancy;
• the use of hormones to prevent unwanted pregnancy.

The level of fibrinogen (Fib)

Coagulation also includes analysis on protein diatomic glipoprotein - a precursor to fibrinogen and fibrin, which is the essence of the thrombus, where the minimum to form a dense clot is 0.49 g / L. The second feature of diatomic protein is that it takes part in the dissolution of fibrin seals on means of enzymatic reactions.

Characteristic values ​​(g / l) - 1,79-3,49.

Raising the standard values:

• acute infectious disease in the body;
• increased myocardial oxygen demand;
• circulatory disorders of the heart muscle;
• stenakardiya unstable;
• acute damage to the heart muscle;
• long flowing form of thrombosis in capillaries and arterioles;
• acute ischemic stroke;
• operations;
• burn disease;
• systemic connective tissue disease;
• inflammation with damage to kidney tubule;
• glomerular nephritis;
• hemolytic-uremic syndrome;
• general swelling due to the injury of the urinary system;
• tumors of various etiology;
• nicotine dependence.

Lowering of normal values:

• blood clots in capillaries and arterioles;
• hereditary coagulopathy;
• in infants because of the insolvency of the hemostatic system;
• connective tissue proliferation of the liver;
• poisoning of various etiology;
• of thrombosis therapy.

Prothrombin (F II factor)

One of the most important components of a biological system in humans - is an enzyme prothrombin. The enzyme produced by the liver, with the assistance of hydrophobic and lipophilic vitamins. MF or prothrombin time in seconds is determined - indicates the duration of the plasma clot after the addition of the chemical.

Prothrombin standards - 9,89-12,11 sec.

Extension factor F II:

• pharmacological therapies to facilitate disruption of formation of prothrombin in the liver;
• hemophilia C;
• lack of lipophilic and hydrophilic vitamins;
• long flowing progressive pathology gepatobilliarnoy system;
• Hemorrhagic diseases;
• lupus;
• properly conducted test.

Reduction in prothrombin time:

• thrombophilia;
• an abnormal increase in the total weight of the erythrocytes;
• increase in the total content of the liquid portion of blood globulins;
• therapy with barbituric acid derivatives;
• reception lipophilic vitamin;
• corticosteroid system;
• hormonal contraceptive therapy;
• antiallergic drugs;
• cancers.

Prothrombin in% for SWIR

Calculation of protein in% of the prothrombin - a prothrombin time dependence of quantitative content% groups of glycoproteins the liquid portion of blood. Form in% - used by the whole world, and is a more accurate definition of the disease or an increased amount of prothrombin.

Prothrombin activity% norm - 69-131%.

Decrease in% of content:

• receiving medicines affecting the production of prothrombin liver;
• congenital bleeding disorder;
• deficiency of vitamins K;
• pathological processes in the liver cells;
• violation of coagulation;
• systemic autoimmune disease;
• wrong to take a blood sample from the patient.

% Increase -th lines:

• increased formation of blood clots;
• increase in globulin in the blood;
• use of drugs barbituric acid;
• the use of hydrophilic vitamins;
• steroid therapy;
• receiving hormonal contraceptive drugs;
• antihistamine drugs;
• malignant neoplasms.

The clotting time Lee-White

The principle of hemostasis Lee-White is based on the use of centrifuges and two vessels with the liquid portion of blood. determination procedure is as follows: should take two clean, identical container, which must be set in a water bath.

It is necessary to make a puncture in the vein of a wide needle and substitute one vessel. When the manifestation of the first drops of blood should start the stopwatch - thus gaining the first container 1 cu. ml of blood. Substituting doing a second vessel and the same procedure - noting the time on the stopwatch, and set both the container in a water bath.

This is followed in turn flip the tubes at an angle up to 70 degrees and track when the blood in the vessel ceases to move (at the same timing with the time on the stopwatch).

Interpretation of the results: the total time of the blood clotting from the start of the stopwatch with the first vessel to the end of the stopwatch with the second, called the time of blood clotting. To obtain more accurate results to be subtracted from the total time correction for the difference in terms of a stopwatch in vitro 1st and the 2nd.

Increasing the time:

• child bearing;
• hypovolemia;
• lowering platelet count;
• an inherited disorder of platelet function;
• blood cancer;
• liver cell damage of connective tissue;
• a sharp drop in the platelet count in the blood;
• constitutional trombopatiya;
• absence of fibrinogen in the liquid portion of blood;
• congenital deficiency of protein factors of hemostasis;
• prothrombin deficiency in the blood;
• paragemofiliya;
• capillary leak syndrome;
• long-term use of aspirin.

lowering:

• pathological condition of the body in which not produced enough red blood cells, white blood cells and platelets;
• consumption coagulopathy.

Thrombin time (TT, TV)

The time period for the conversion of fibrin in the thrombus, the basis of which it is, by adding to the liquid portion of the blood clotting enzyme II, called thrombin time. Various types of pathological disorders of the quantity and quality of a colorless protein fibrinogen, will change the time of coagulation.

The normal period of clot formation - 13,99-20,98 seconds.

Extension of Time:

• abnormal lack of fibrinogen in the blood;
• blood clots in capillaries and venules;
• long-occurring disease gepatobilliarnoy system;
• systemic treatment with heparin;
• child bearing;
• breast period.

Abbreviation:

• a sharp increase in pathological protein fibrinogen in the blood;
• increasing the number of platelets in the blood.

Indicators clotting enzymes

During the biological process of hemostasis is complete without special enzymes that are necessary to form dense clusters:

• thrombin - it is a serine protease (enzyme) that helps in the process of fibrin clot formation;
• the initiator of blood coagulation - blood coagulation factor III;
• not protein-bound calcium - Party forming dense bunches. Normally - 0,089-0,1 g / l;
• coagulation enzyme VII - increases the rate of clotting. Norm - 49-149%;
• Factor VIII enzyme- - in the absence of proteinaceous compounds developing hemophilia. Normal% - 59-144%;
• proenzyme responsible for the clotting of blood. Percentage enzyme normal operation - 59-141%;
• factors IXa, VIIIa - a complex of enzymes involved in the prothrombinase. The norm in the liquid portion of blood 0.029 g / l;
• plasma AC Globulin - plasma is contained in an amount of 0.099 g / l;
• X is an enzyme, Directly involved in the process of prothrombin. Is contained in an amount of 0.099 g / l;
• antihemophilic enzyme - XI, Thromboplastin receiver. The liquid portion of the blood - 0,0049g / L;
• contact XII enzyme produced by liver cells and found in the blood in an amount of 0.029 g / l.

Time and activated plasma recalcification (GRP and ATS, respectively)

Recalcification liquid portion of blood - is the time necessary for the formation of a dense clot after adding calcium chloride. As a rule, the process rate is invested in 49-71 seconds. Raising - a sign of pathological process in the platelets or containing heparin uncontrolled intake of medicines.

Lowering the speed is associated with increased blood clotting, but does not show any specific pathologies. Activated time - a state of coagulation of blood on one of the stages of the process. The test is performed using calcium salts. Normal values ​​varies - from 49 seconds. to 71 sec.

Acceleration of ATS:

• thrombocytopenia;
• primary or secondary thrombotic enzymes insufficiency;
• protivotrombinovymi treatment drugs;
• burn disease;
• state of shock.

lupus anticoagulant

Heterogeneous group of antibodies that are directed against the negative lipids called - lupus anticoagulant. This is the main indicator test for the diagnosis of multisystem disease, which produces a pathologically large number of antibodies to lipids.

Result:

• negative - 0,79-1,199;
• dubious - 1,2-1,49;
• moderate - 1,5-1,99;
• positive - 2.0.

Pathology in a ratio of 1.2:

• systemic connective tissue disease;
• cancers;
• viral infection;
• stroke;
• thrombosis;
• characteristics of the organism, as the rate of 4% of the world's population.

D-dimer

Dimers - a protein fragment of the blood clot after fracture (fibrinolysis process). The indicator provides a high degree of accuracy to exclude or confirm the thrombus.

Normal - to 0.499 ug / ml

Above the normal figure:

• secondary thrombosis of capillaries and arterioles;
• sudden lack of oxygen myocardium as a consequence of arterial thrombus blockage;
• ischemic stroke;
• post operative period;
• the use of hormonal contraceptives;
• systemic corticosteroid therapy;
• long flowing inflammation in the body;
• acute inflammation;
• normal and pathological pregnancy.

The soluble fibrin monomer complex (SFMC)

Complexes of fibrin monomers and fibrin degradation products and fibrinogen - a soluble fibrin monomer complexes. An indicator of the pathological formation of micro clots in blood vessels. Normal - to 3.38 mg / l 0.1.

Above the normal figure - a pathological process:

• in the urinary tract, gepatobilliarnoy and respiratory systems;
• systemic connective tissue disease;
• cardiovascular diseases;
• tumoral process of various etiology;
• varicose veins;
• nicotine addiction;
• ECO;
• bearing of twins or more children.

platelets

blood cells, which are formed in the bone marrow, called platelets. Any damage to blood vessels activates platelets systems that have the ability to stick to the wall of the damaged vessel, thus stopping the bleeding.

Normal values ​​in the range of 180-360 cells / liter.

lowering:

• thrombocytopenia;
• autoimmune pathological processes in the body;
• decrease in hemoglobin levels with the presence shizotsitov;
• pathology in the vascular system;
• viral diseases;
• heat;
• malignant purpura.

Improving results:

• strong physical exertion;
• delivery is;
• congenital abnormality increased platelet count;
• disease of bone marrow cells;
• malignancy of myeloid blood germ;
• inflammatory processes in the body;
• recovery from thrombocytopenia;
• lack of mineral iron;
• the post operative period.

protein C

Protein C - anticoagulant which is produced in liver cells. Is directly involved (together with a protein S) to be diluted blood, exhibits anti-inflammatory action in the body as a whole. Normal values ​​of anticoagulant activity - 70-130%. The increased rate is not important from the point of view of medicine.

Lowering the value:

• inflammatory process in the body of various etiology;
• acute coronary syndrome;
• thrombosis of capillaries and arterioles;
• pathologies of the digestive system;
• oncological diseases;
• child bearing;
• lack of education pechechnyu protein;
• gepatobilliarnoy pathology and urinary systems;
• autoimmune connective tissue disease;
• inflammation of the brain;
• AIDS;
• secondary postoperative complications;
• reduction of neutrophils in the blood.

Antithrombin-III

Serine proteases that are produced by the liver cells - a antithrombin-III. As an independent substance inefficient, but in combination with heparin, blood clotting quality improves. Normal values ​​in the range of 79-121%.

Increase in%:

• heparin therapy;
• lack of lipophilic vitamin;
• hepatitis B and C;
• long proceeding inflammatory diseases in the body.

% Decrease -th lines:

• congenital abnormality failure serine protease;
• thromboembolism;
• ischemic stroke;
• sharp myocardium oxygen deficiency due to arterial occlusion thrombus;
• severe bleeding;
• cancerous growths;
• recent weeks gestation pregnancy (30-38);
• use of a large number of hormonal contraceptive preparations.

protein S

Antikoagulyarny blood factor protein S and is responsible for hemostasis complement protein C. Normal indicator protein content depends on the synthesis of hydrophobically lipophilic vitamins and is responsible for blood clotting. Standard indicator - 64-141%.

Decreased%:

• AIDS;
• HIV;
• Hepatitis C and B;
• thrombosis of capillaries and arterioles.

Raising rates is not used in the diagnosis of diseases and is of no interest to physicians.

Normal values ​​of parameters hemostasiogram

Coagulation - a test that evaluates the activity of the biological systems of the body responsible for the quality and density of the blood. To determine the normal values ​​of parameters exist, the values ​​are held by physicians in the diagnosis of many pathological processes in the body of adults and children.

Standard indicators for adults:

• time in minutes. during which blood coagulates - 5,1-10,1 min;
• PTI - 79-121%;
• time for clot formation (TV) - 10,9-17,7 seconds;
• the amount of substance fibrinogen - 1,99-4,1 g / l;
• colorless liquid portion of blood protein fibrinogen - 5,8-11,6 .mu.mol / l;
• The fibrinogen - negative;
• Activation of fibrinogen - 182-264 m;
• calcium clotting AVR - 49-71 seconds;
• partial APTT time - 23-36 seconds;
• screening coagulation status - trombotest - 4-5 v .;
• inactivity of the liquid portion of blood to the heparin - 2-10 minutes;
• duration no coagulation on Duque - 3.8 min;
• cut and seal blood - 43-66%;
• SFMC - up to 3.89 mg / l 0.1;
• GRP - 59-121 seconds.

For children while Lee-White:

• 1-3 years - 6,0-1,9 m;
• 3-7 years - 6,8-1,54 min;
• 7-14 years - 5,9-1,5 m.

Trombotest:

• 1-3 years - 3,9-6,1 v .;
• 3-7 years - 3,9-6,1 v .;
• 7-14 years - 3,9-6,1 Art.

prothrombin index:

• 1-3 years - 82,2-98,8%;
• 3-7 years - 86,2-100,7%;
• 7-14 years - 84,4-93,3%.

Level colorless liquid portion of blood protein fibrinogen:

• 1-3 years - 2,3-3,7 g / l;
• 3-7 years - 2,2-3,6 g / l;
• 7-14 years - 1,9-3,1 g / l.

The inactivity of the plasma to heparin:

• 1-3 years - 6,4-8,4 m;
• 3-7 years - 6.7-7.3 min;
• 7-14 years - 5,1-6,1 m.

1. Platelets - from 130 to 401 thousand / ml.
2. Clotting time - 3,9-9,1 m.
3. Substance fibrinogen - 5.8 - 11.6 m / l.
4. Conversion of fibrinogen to fibrin - 30 min + -not more than 2.5 min.
5. APTT - more than 69%.
6. The formation of a blood clot - 23-36 seconds.

Coagulation during pregnancy

Coagulation - binding analysis when carrying a pregnancy. The survey results show just the doctor gynecologist bleeding tendency, or vice versa - to thrombosis, which can not be allowed in this period of life of women. Indicators for 1,2,3 trimester.

Colorless protein fibrinogen:

• 1-12 Week - 2.97 g / l;
• 13-28 week - 3.0 g / l;
• 29-38 week 0 4.94 g / l.

PTI:

• 1-12 weeks - 85.4%;
• Week 13-28 - 89.2%;
• Week 29-38 - 108.7%.

The formation of a blood clot:

• 1-12 weeks - 227.3 seconds;
• Week 13-28 - 257.3 seconds;
• Week 29-38 - 329.3 sec.

Platelet count:

• 1-12 Week - 300 * 10 / L;
• Week 13-28 - 289 * 10 / l;
• Week 29-38 - 329.3 * 10 / l.

SFMC:

• Week 1-12 - 77-129 units .;
• Week 13-28 - 84-136 units .;
• Week 29-38 - 89-141 units.

ATS:

• 1-12 weeks - 59,9-72,4 seconds;
• Week 13-28 - 55,9-67,2 seconds;
• Week 29-38 - 47,9-55,1 seconds.

Deciphering hemostasiogram during pregnancy

It is not always any deviations coagulogram - it's pathology. There is a human factor - when not properly test or pregnant woman was taken eaten before the analysis (night snack).

But there are pathological conditions which predispose increase or decrease in the result of analysis:

• psycho-emotional instability (which is very common during pregnancy);
• infectious diseases;
• long-occurring disease of the urinary system;
• diseases of the endocrine glands (pituitary, thyroid);
• malignant neoplasms.

Any of the above pathological conditions can trigger:

• decrease in hemoglobin;
• lack of oxygen to the fetus;
• placental abruption is not time;
• fetal death.

Where can I get tested

Test for hemostasis work can take place in the usual urban clinic. But in public health facilities do not always have all the necessary markers for passing expanded coagulation. To do this, choose a commercial laboratory. Desirably, before the test, ask about the presence of certificates and reviews of the facility.

Coagulation and detailed test work hemostatic system will differ in price because of the amount of definition of indicators:

• coagulogram costs - ranging from 660 rubles. 700 rub .;
• hemostasiogram (extended) - the price varies from 3450 rubles. up to 3560 rubles.

In time to prevent acute diseases should be once a year to make coagulation analysis. This is a test that will help to understand many pathological conditions.

Useful video of coagulogram and diseases, which are revealed by this analysis

Norms and deviations in the results of coagulation:

How is the analysis: