1 Prothrombin
What is this blood test for the coagulogram, and also how important it is for the patients, it becomes clear if they have to face surgical intervention, childbirth that involves a lot of blood loss. Not the least role analysis of the blood coagulogram plays in diseases of the liver, blood vessels, pathological deviations of the body's immune system. This type of diagnosis is a complex analysis, which can be carried out by different methods, which requires the determination of some factors:
- of bleeding;
- of prothrombin and thrombin time;
- content of fibrinogen;
- an indicator of lupous anticoagulant;
- availability of fibrin degradation products;
- antithrombin III.
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These ingredients give an accurate understanding of what a coagulogram is and what it consists of. So, the main element that influences the analysis is prothrombin. To determine its index, take blood on an empty stomach from the vein at the elbow. Clotting time is determined by the puncture of the skin tissue, then the time is fixed, after which the bleeding stops.
There are certain norms of coagulogram. The time limit for clotting is 2-3 minutes. If it is enlarged, it indicates a lack of platelets, which can be triggered by diseases of the blood, liver and kidneys. In addition, the decoding of the coagulogram affects such indicators as:
- Fibrinogen is a colorless protein soluble in the plasma that precedes the fibrin and is a part of the thrombus carcass. Its normal value is 2-4 g / l.
- Thrombin time shows how much time from soluble fibrinogen can produce insoluble fibrin. The normal indicator of this process is 14-16 seconds.
- INR - The international normalized ratio determines the tissue factor of blood coagulation. Its rate should be - 0,8 - 1,2.
- APTT is a thromboplastin time that shows the period during which a blood clot forms during the addition of a chemical to the plasma. Its rate in the absence of pathology is 30-40 seconds.
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2 Analysis components
The coagulogram decoding also includes other indicators:
- Antithrombin is one of the main anticoagulants. Its permissible norm in the process of blood coagulation should be from 71 to 115%.
- Protein C is also one of the main components of the anticoagulant system of blood. Optimum parameters of its quantity range from 80 to 120%.
- The time index of recalcification of blood plasma determines the period from the onset of the addition of calcium salts to the blood plasma and the formation of a clot. Normally this time should be from 1 to 2 minutes.
- D-dimer is the moment of destruction of fibrin in the process of decomposition of thrombus. The rate of this destruction is up to 500 μg / l.
- Groups of fibrin and fibrinogen as a result of the activity of the clotting process form soluble monomeric complexes of fibrin. Normal is considered to be an indicator of 3.36 mg in 100 ml.
- A specific antibody to certain blood enzymes is a lupus anticoagulant. At a normal rate during coagulation it should not be.
- Plasma transportability of heparin, which is an anticoagulant. Its indicator has a time component, fixing the time in minutes, which is spent during the recalcification of the plasma after the addition of heparin. Normal indicators should not exceed 10-16 minutes.
- Platelets, which are elements of blood involved in the process of hemostasis. Indicators of coagulogram, fixing their normal number, - 150-400 thousand / μL.Only with poor health or during pregnancy this indicator can be reduced to 130 thousand / mkl. With a very low level of platelets, the DIC syndrome can develop.
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3 Preparation for
research Although the process of blood sampling is performed by a specialist, you need to know how to donate blood for analysis. The main requirement is to give up food a few hours before the blood test. Analysis of the clotting system is not basic, therefore, when and how to surrender it, a specialist should appoint and consult.
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In the event that the physician has determined violations in the process of blood coagulation for any laboratory or clinical signs, a full coagulogram of blood is assigned to the patient. In some cases, it is prescribed as a prophylaxis. Take blood on a coagulogram can with frequent and prolonged bleeding. The reason for making an analysis for a coagulogram can be constantly and easily arising bruises on the body from minor touching or bruising. Blood on the coagulogram helps to identify failures in the state of the immune system of the human body, the development of diseases of the cardiovascular system and the liver. A compulsory analysis of the coagulogram is done before surgery, which involves a considerable loss of blood, and before labor.
To determine how accurately the treatment is selected by these or other medications that can have a pronounced effect on hemostasis, this analysis is also done. These drugs include anticoagulants, combined oral contraceptives, antiaggregants.
Depends on the coagulogram, the norms of its indicators on the correctness of the delivery of the analysis. You can not eat before this procedure for 8 hours, you can drink only water. At this time, it is strictly forbidden to drink alcoholic beverages. In addition, doctors forbid even to smoke for 1-2 hours before taking blood. The physical and emotional state of the patient should also be normal. Before donating blood, you need to inform the doctor about which medications that can affect the blood coagulation index, is taken or received shortly before the test is given to the patient.
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4 Pregnancy
An important coagulogram in pregnancy, as during this period in the body of a woman there are special physiological processes. Changes in the hormonal background of a pregnant woman have their negative consequences, one of which is the process of hemostasis violation, which leads to an increase in blood coagulability. Despite the fact that this phenomenon is aimed at preserving and assisting in the development of the fetus, the analysis of the coagulogram in pregnancy is mandatory.
An out-of-schedule coagulation test may be prescribed by a physician at such factors as:
- pregnancy has a complication in the form of proliferation, underdevelopment of the fetus in the womb;
- pregnancy with IVF;
- if it was difficult for a woman to become pregnant;
- Gestapo early or late stage, fetoplacental insufficiency;
- strong varicose veins;
- smoking during pregnancy.
In addition, this kind of analysis is done to determine the condition of the liver. Coagulation allows an assessment of how the liver functions by tracking the constituents of the prothrombin complex in it. Be sure to conduct an analysis of the coagulability of women, long time taking drugs that are based on heparin. With the assumption of a factor of blood clotting disorder in a woman, the doctor can, on the basis of this, assign an extended analysis.
In the normal course of the process of carrying a child to a woman for 9 months, it is necessary to make a coagulogram in pregnancy 3 times. The first time - with a primary medical examination in the women's consultation, then - at 22-24 weeks and at 30-36 week.
A coagulogram in pregnancy allows early detection of abnormalities in blood clotting, which can provoke placental detachment and bleeding. As a result, a miscarriage may occur. With an increase in the clotting factor, the child's brain can suffer. Doctors advise to make a coagulogram during pregnancy and during her planning, which will avoid serious consequences.
The conditions that the doctor voices before taking blood for coagulation are the general standard recommendations:
- is not 8 hours before the analysis;
- not to drink sweet, alcoholic and carbonated drinks, except water;
- do not smoke;
- be calm and balanced.
5 Decoding of
If a woman's condition does not bode any problems, she has such indicators of this analysis during pregnancy:
- coagulation time - 5-7 minutes;
- fibrinogen - 3-6 g / l;
- thrombin time - 18-25 seconds;
- MNO( in the range) - 0,65-1,1;
- APTTV - 25-27 seconds;
- antithrombin - 85-100%;
- plasma recalcification - 35-60 seconds;
- protein C - 85 -170%;
- D-dimer - less than 248 μg / l;
- lupus coagulant not detected;
- plasma tolerance to heparin - more than 16 minutes.
An extended coagulogram is prescribed by the doctor only if there are no abnormalities in the standard analysis. Decoding is carried out by a gynecologist in a hospital.
Prothrombin and INR are an important factor in pregnancy. In time, the observed deviations can help prevent the development of thrombosis, detachment of the placenta and large blood loss during labor. Therefore, the analysis is recommended for each trimester. The level of prothrombin makes it possible to identify problems in the functioning of the liver and digestive system. This substance is produced in the liver with the help of vitamin K.
If the level of prothrombin is low, then the body does not cope with its work, there is a low level of vitamin K production or a woman has gastrointestinal diseases. Elevated levels indicate a tendency to thrombosis.
The rate of formation of the blood clot determines the INR.If the pregnant woman has taken or takes coagulants, then her indicator is calculated for her. If the index is low, there is a possibility of formation of thrombosis. A high level can provoke bleeding. Regulate the level of INR drugs, reducing the risk of blood clots.
APTT is the time taken to form a blood clot. An increased time indicator in a pregnant woman is prone to severe blood loss, hemophilia, an increase in the production of antibodies to phospholipids.
Fibrinogen is the main component of a blood clot forming a thrombus. Its increase can talk about the lack of thyroid hormones, the flow of acute respiratory disease, the violation of protein metabolism. With an increase in thrombin time, the risk of developing liver pathology increases, in the blood serum of bilirubin. ATZ( antithrombin) inhibits coagulability, thereby blocking the formation of thrombi. The increase in ATP is observed in acute hepatitis, cholestasis, inflammatory processes. A low level indicates a plugging of veins with a thrombus, atherosclerosis.
Increased D-dimer demonstrates in the body of a woman signs of infection, inflammation, liver disease. If a lupus anticoagulant is detected, it can talk about early thrombosis, cerebral circulation, threat of miscarriage.
- 1 Prothrombin
- 2 Components of analysis
- 3 Preparation for
- 4 study Pregnancy
- 5 Decoding
Coagulogram indices can give only an approximate idea of the state of coagulation disorders. To obtain accurate information, each of the 13 biochemical clotting factors is examined. Of particular importance is coagulation in pregnancy, deciphering it helps to prevent the negative consequences in the development of the fetus associated with a violation of blood coagulability.
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