In the article, we will consider how to pass a coagulogram.
This is a special laboratory study in which the features of blood coagulation are determined. This analysis plays an important role in the study of the patient's condition.
It is important to know how to take a coagulogram test. Its values help to suggest how successful the delivery or surgical intervention will be, whether the patient will survive, whether bleeding can be stopped in a critical situation. However, not all specialists have the ability to read a coagulogram. But precisely such a study often becomes a factor in saving human life.
So, we will understand what a coagulogram is, and why they donate it.
Blood is a biological fluid that has the ability to circulate through the vessels and form clots (blood clots). This quality allows her to close the gap in the small and medium veins and arteries, and sometimes this process goes unnoticed by humans. Blood coagulation and its preservation in a liquid state is regulated by the body system, which has the name "hemostasis".
This biological system consists of three main components:
- Vascular cells, namely the inner layer of blood vessels (endothelium) - when a vessel wall ruptures or is damaged, endothelial cells secrete a number of active substances (prostacyclin, nitric oxide, thrombomodulin) that trigger thrombus formation processes.
- Platelets are special blood plates that rush to the site of damage first, after which they stick together and close the wound, forming a hemostatic plug. If these blood plates cannot stop the bleeding, the plasma properties of blood coagulation are included in the process.
- Plasma factors - hemostasis includes 15 such factors (many of them are enzymes) that, as a result of a series of chemical reactions, form a fibrin clot of a dense structure, which finally stops bleeding. A feature of these coagulation system factors is that almost all of them are produced in the liver using vitamin K.
The processes of human hemostasis are also controlled by fibrinolytic and anticoagulation systems. Their main function is to prevent spontaneous thrombosis.
How to pass a coagulogram, it is important to find out in advance.
Indications for appointment
The list of main indications for the appointment of a hemostasiogram includes the following:
- general assessment of the hemostatic system;
- cesarean section or independent birth;
- scheduled studies before surgery;
- gestosis, occurring in severe forms;
- control of treatment with indirect anticoagulants (Warfarin, Aspirin, Trental), heparin medicines (Fraksiparin, Kleksan);
- diagnosis of a variety of hemorrhagic diseases (von Willebrant disease, hemophilia, thrombocytopathy and thrombocytopenia);
- varicose veins of the lower extremities;
- with a high probability of thrombosis (with atrial fibrillation, coronary heart disease);
- definition of DIC;
- the use of oral contraceptives, anabolics, glucocorticosteroids;
- chronic liver disease (cirrhosis);
- acute inflammatory processes in the body;
- in the diagnosis of various thromboses - intestinal vessels, lower extremities, pulmonary thromboembolism, ischemic stroke.
How to pass a coagulogram, the doctor will tell.
Study Preparation
The preparation for this study is of great importance.
Many are interested in how to take a coagulogram - on an empty stomach or not.
Biological material is taken on an empty stomach. In this case, it is necessary that the meal was at least 12 hours ago. Before taking the test, it is not recommended to use spicy, smoked, fatty foods, alcoholic drinks, smoking is strictly prohibited.
Everyone should know how to donate blood to a coagulogram.
Another important condition is to stop taking anticoagulants of indirect and direct action, since their presence in the blood can significantly distort the performance of laboratory tests. In cases where taking such medications is a vital condition for the patient, it is necessary to warn the specialist who will conduct the study. So how to pass a coagulogram?
How is a blood coagulation test performed?
Biomaterial is taken using a sterile dry syringe or a special Vacutainer blood collection system. This event should be carried out using a needle with a wide clearance without using a tourniquet.
A vein puncture must be atraumatic, otherwise a large amount of tissue thromboplastin will fall into the test tube, which also significantly distorts the analysis results. The laboratory assistant fills 2 tubes with blood, while only the second is sent for the study. The tube should contain sodium citrate (special coagulant).
Is it possible to take a coagulogram during menstruation? This is a common question. We will talk about this at the end of the article.
How many days do a coagulogram?
To obtain the correct research results, the laboratory assistant carries out certain chemical reactions, which take some time. This process usually takes 1-2 days. However, a lot of this depends on the workload of the laboratory, the work of employees, the availability of reagents.
We are not in vain telling you how to pass a coagulogram correctly. The accuracy of the results depends on this.
Coagulogram norms
Normally, hemostasis indicators are as follows:
- the coagulation period is 5-12 minutes;
- bleeding period - from 2 to 8 minutes;
- prothrombin time - 11-15 seconds;
- APTT thromboplastin time 22.6-35.8 sec;
- activated period of recalcification ABP 82-126 seconds;
- prothrombin index - 72-123%;
- thrombin time - 14-21 seconds;
- fibrin-monomer complexes - 0.356-0.478 U;
- antithrombin III - 75.9-124.6%;
- D-dimer - 250.09-500.48 ng / ml;
- fibrinogen 2.6-4.023 g.
Why give a coagulogram, what indicators does it reveal?
Decryption
In order to correctly understand the significance of this analysis, it is necessary to familiarize yourself with each of its indicators in more detail, since they reflect the most important properties of the blood of a particular patient. When decoding, regulatory values for a certain age are taken into account.
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Prothrombin time is the period of formation of a blood clot if thromboplastin and calcium are added to the plasma. This indicator reflects two phases of plasma coagulation and the functionality of 10, 7, 5 and 2 factors. The norms of prothrombin time at different ages are:
- premature babies - 13-18 seconds;
- full-term children - 12-16 seconds;
- young children - 14-17 seconds;
- older children - 12-16 seconds;
- in adults - 11-16 seconds.
Anticoagulant treatment is considered effective if this indicator rises at least 2 times.
INR
INR (prothrombin coefficient) is the ratio of the patient's PV in the control tube's PV. The main goal of evaluating INR is to control the administration of indirect anticoagulants. The reasons for the change in INR indicators are:
- lengthening of prothrombin time;
- liver diseases (hepatitis, cirrhosis);
- vitamin K deficiency with enteropathy, dysbiosis;
- nephrotic syndrome;
- amyloidosis;
- DIC; hereditary insufficiency of coagulation factors (10, 7, 5, 2);
- absence or decrease in fibrinogen concentration;
- Coumarin derivative therapy (Merevan, Warfarin);
- anticoagulant medication;
- thromboembolism and vascular thrombosis;
- increased activity of 7 factors;
- fibrinolysis activation.
Taking a coagulogram on which day of the cycle is interesting to many women.
APTTV
This indicator indicates partial activated thrombin time, the effectiveness of stopping bleeding by plasma factors. APTT reflects the path of hemostasis, and how quickly a fibrin clot forms. This is the most accurate and sensitive indicator of hemostasiogram. APTT depends on the applied specialist reagent activators. Shortening of the APTT indicates high coagulability, the likelihood of blood clots, and lengthening indicates a decrease in hemostasis. Reasons for changing this value:
- acquired or congenital insufficiency of factors (12,10,9,8,5,2);
- fibrinolysis;
- DIC;
- therapy with heparin and its analogues (Zibor, Kleksan, Fraksiparin);
- autoimmune diseases (lupus erythematosus);
- pathologies of the liver of severe forms (fatty infiltration, cirrhosis);
- high blood coagulability;
- improper blood sampling (tissue thromboplastin contamination).
ABP
Activated recalcification time is the period necessary for the formation of fibrin in the blood, saturated with platelets and calcium. This value reflects how effectively the cellular and plasma links of hemostasis interact. The rate may vary by reagent. AVR is prolonged with a decrease in the number of platelets (thrombocytopenia) and a violation of their quality (thrombocytopathy), as well as with hemophilia. ABP is shortened in the presence of a tendency to thrombosis.
PTI
The prothrombin index is the ratio of the normal prothrombin time to that observed in the patient, and is multiplied by 100%. This indicator increases with:
- deficiency of hemostasis factors;
- vitamin K deficiency (enterocolitis, colitis);
- therapy with indirect anticoagulants (Neodicumarin, Warfarin, Sincumar);
- treatment with Heparin, Clexane, Flenox;
- lesions of the liver;
- vascular thrombosis;
- increased coagulation during pregnancy or childbirth.
Tv
Thrombin time reflects the final stage of hemostasis. It characterizes the time period required for the formation of a fibrin clot if thrombin is added to the plasma. This indicator is determined together with PV and APTT to control heparin therapy and fibrinolytic diagnosis of pathologies of congenital fibrinogen. Factors lengthening thrombin time are:
- acute fibrinolysis;
- treatment with fibrinolytic drugs ("Urokinase", "Streptokinase");
- DIC;
- autoimmune diseases (the presence of antibodies to thrombin);
- liver disease
- therapy with fibrin and heparin inhibitors.
Fibrinogen
This is one of the factors in blood coagulation . This protein is formed in the liver and under the influence of Hageman factor and is converted into insoluble fibrin. Fibrinogen is classified as an acute phase protein; its plasma level rises with stress, infections, and injuries. This indicator may change in the following cases:
- severe inflammatory pathologies (peritonitis, pyelonephritis, pneumonia);
- systemic pathologies of connective tissue (SLE, rheumatoid arthritis, scleroderma);
- myocardial infarction;
- oncological tumors;
- pregnancy;
- burn disease;
- amyloidosis;
- after surgical interventions;
- menstruation period;
- therapy with heparin and its analogues, as well as estrogens (use of hormonal contraceptives);
- DIC;
- leukemia, aplastic lesions of bone marrow;
- liver pathology;
- prostate oncology with metastases;
- conditions after bleeding;
- treatment with androgens, anabolics, barbiturates, valproic acid, fish oil, fibrin polymerization inhibitors;
- heparin poisoning
RFMK
This indicator is soluble fibrin-monomeric complexes, which are intermediate products of the decomposition of a fibrin clot as a result of fibrinolysis. They are very quickly removed from plasma, the indicator is extremely difficult to determine. RFMC increases with:
- thrombosis of various localization;
- in the postoperative period;
- pregnancy complications (gestosis, preeclampsia);
- renal failure;
- shock;
- sepsis
- systemic pathologies of connective tissue.
Antithrombin III
This is a physiological anticoagulant substance. In structure, it is a glycoprotein that inhibits thrombin and some coagulation factors. The main place of its production is liver cells. A change in the level of this substance occurs when:
- severe inflammatory diseases (pyelonephritis, peritonitis, pneumonia);
- acute liver damage (hepatitis);
- lack of vitamin K;
- therapy with anabolics, glucocorticosteroids;
- hereditary and congenital deficiency;
- liver pathologies (cirrhosis, alcoholic disease);
- DIC;
- Ischemic heart disease;
- late pregnancy;
- thrombosis and thromboembolism;
- sepsis
- treatment with heparin and fibrin polymerization inhibitors.
D-dimer
This value characterizes the remains of split fibrin filaments and the work of hemostasis. If the D-dimer is elevated, it means that too much fibrin has broken down. It is contained in the blood for about 7 hours after its formation, so the biomaterial must be examined immediately. Diagnostic value is the increase in this indicator, which is observed when:
- thrombosis and thromboembolism;
- liver diseases;
- Ischemic heart disease and heart attack;
- extensive hematomas;
- in the postoperative period;
- prolonged smoking;
- rheumatoid seropositive arthritis;
- DIC syndrome.
Bleeding time
Coagulation time indicates the interval required to form a blood clot. In practice, only an increase in this indicator is estimated, since this indicates:
- platelet deficiency;
- hemophilia;
- damage to the liver with alcohol;
- hemorrhagic fever;
- thrombocytopathy and thrombocytopenia;
- an overdose of anticoagulants and anticoagulant drugs.
Is it possible to take a coagulogram during menstruation?
Menstruation analysis
This laboratory test during menstruation, as a rule, cannot give a clear result. This is due to the fact that during this period the blood is most diluted, and it is not possible to check its coagulation properties.
That is why it is so important to figure out how to pass a coagulogram. Especially when it comes to women.
Therefore, to implement this procedure, it is best to wait until the end of menstruation, but do not analyze immediately after it. The body in this period is interested in removing blood from the uterus, so coagulation is in some way impaired. After the critical days, all processes of a similar nature return to normal, and the patient may well go for tests.
There were cases when women took a coagulogram during menstruation. Their results were unreliable.
Before the onset of menstruation, it is also not recommended to conduct a similar procedure, since the body is preparing to withdraw blood, which in this period is already gradually thinning. The analysis will be incorrect and will have to be repeated.
On which day of the cycle should I take the coagulogram?
The most optimal time for this laboratory analysis in women is 5 days before the onset of menstruation and the same after its completion, that is, 10-20 days of the cycle. In this period of time, the result will be the most reliable.
We examined what a coagulogram is and why they donate it.