The abbreviation INR is unknown to many. Usually its meaning is understood only by medical professionals. Those who have not previously had to take such an analysis, and whose relatives have not been prescribed it, first hear about this test from their doctor. Find out how this abbreviation stands for medicine and get acquainted with the features inherent in the blood coagulation system. After reading this article, you will understand why they conduct a text analysis of INR, what should be the frequency of appointment and normal indicators, and where they suggest an analysis.
Features of the blood coagulation system
The normal level of blood density is achieved as a result of the joint coordinated work of the coagulation and anticoagulation system. The liquid state is maintained by anticoagulation mechanisms. And the process of thrombosis is controlled by them. When there is no balance, problems appear in the form of increased bleeding and the formation of blood clots.
When performing a comprehensive blood coagulation test, special attention is paid to the level of prothrombin, which is a complex protein. Another name for this substance is used - factor II. Prothrombin is produced in the liver, for its presence in a normal amount, it is important to provide the body with the required volume of vitamin K.
How to check the status of this system?
It is the prothrombin protein that reflects the features of the functioning of the coagulation system. By its level, one can judge the risk of thrombosis and bleeding. The prothrombin content is established by applying the following methods:
- INR;
- PTV;
- PTI;
- Quick technique.
Most often, patients are prescribed INR and the prothrombin index technique, because according to the results of these analyzes, the work of the coagulation system can be assessed in the best way.
INR effectiveness
The abbreviation stands for "international normalized ratio." The test is carried out in laboratory conditions, its results are extremely important, because according to them the doctor receives the required information in the right amount. During the analysis, the prothrombotic time for a particular patient is determined. As a result, the normative indicator characteristic of a healthy organism is compared with the indicator established for the patient who underwent the study.
Using this standardization of protein values, on the basis of various methods of researching the system, doctors were able to obtain a single generally accepted indicator. The INR results are stable; when passing analysis in different laboratories, the indicator is always the same. The effectiveness of the test was confirmed by experts from WHO and international organizations.
Possible disturbances and regulation of prothrombin level
A single standard made it possible to provide reliable control of prothrombin and safe methods for correcting its level. It is possible to adjust the protein content with the help of special medicines that thin the blood. It can be Finilin, Warfarin or Sinkumar.
For patients with a high risk of blood clots, doctors prescribe anticoagulants. Such changes occur during many pathological processes occurring in the body. Among the possible pathologies - thrombophlebitis, myocardial infarction, heart disease. Also, a tendency to increased formation of blood clots is observed with thrombosis and thromboembolic complications associated with coronary insufficiency. A high risk of blood clots is also present with pulmonary embolism.
If, according to the INR results, the norm is exceeded, the doctor has reason to suspect a tendency to bleeding. In this case, it is required to reduce the dose of the previously prescribed anticoagulant. When, after the start of treatment and the passage of the INR analysis, the norm of a particular protein is violated, the values are lower than required, there is a high risk of blood clots. This means that the remedy prescribed for blood thinning does not work properly. The doctor may choose another drug or increase the dose of the previously used medication.
Normative indicators
What is the norm of INR in a person without health problems? When everything is in order with health and there are no serious violations, the protein values are within the range of 0.7-1.3. Most often, the indicator is at least 0.85 and can reach 1.25, that is, about 1. These indicators indicate the absence of violations. In cases where you have to take one of the known anticoagulants, for INR the norm is about 2-3.
It is these quantities that are normal in the situations considered. If the values change in patients who do not take any drugs that affect the blood, the doctor determines certain pathological disorders. The ability to maintain the required protein level is the basis for reliable prevention of thrombosis.
0.8-1.25 - the norm of INR in the blood of women bearing a child. The values of the indicator can vary throughout the pregnancy. Also, after passing the INR, the norm in women depends on age-related changes and hormonal levels. Factors affecting changes in protein levels can be different. Why exactly its content has increased or decreased, the doctor will be able to say after a thorough study of the problem.
It is worth noting that according to the results of INR, the norm for men and women taking different drugs may differ from the accepted standard. To effectively normalize the indicator and the state of health, contact a qualified specialist.
INR blood test, transcript: norm exceeded
When the level of prothrombin is defined as elevated according to the INR results and blood norms are violated, the indicator usually exceeds 1. Such changes may indicate the development of the following diseases and conditions:
- disturbances in the liver;
- pathology of an innate nature from the coagulation system;
- failures that occur during the absorption of fats in the digestive tract;
- vitamin K deficiency;
- the occurrence of negative body reactions to antigout medications, anabolics, antibacterial agents and steroids.
Hypocoagulation is a danger in the form of bleeding that occurs both inside the body and externally. If after INR the norm is significantly exceeded, the indicator is about 6, the patient's condition is critical. Such jumps pose the greatest danger to humans with hypertension, problems in the urinary system and pathologies in the vessels, as well as in the presence of ulcers and inflammation in the digestive tract. If after determining the protein by the INR method, the blood norm is significantly overestimated, the patient requires urgent hospitalization with subsequent therapy.
What to do if the indicators are low?
If, after an INR blood test, the norm is not detected, instead, a decrease in the normal indicator is recorded, the following violations and errors are determined in the patient:
- high antithrombin III content;
- change in hematocrit up or down;
- negative reactions of the body that arose during treatment with glucocorticoids, drugs that have an anticonvulsant and diuretic effect, or after taking anti-conception drugs;
- the study was conducted under conditions when the blood plasma was exposed to a temperature of 4 ° C for longer than permitted by the standards;
- the results are erroneous because the blood was drawn using a catheter located in a central vein.
Changes during treatment with special medicines
If for patients undergoing treatment, decoding of the INR analysis is required, the norm in this case is not always detected. For example, when a person takes the drug "Warfarin" or undergoes therapy based on the use of another drug from the group of anticoagulants, changes may indicate the need to adjust the previously selected dose of the drug.
Reduced blood clotting at high rates according to the results of the analysis should be perceived as a risk of bleeding. To normalize the patient's condition, the doctor takes measures aimed at reducing the dose of the drug and reducing the severity of side effects. Given the vulnerability of blood vessels, external blood loss is possible even due to minor mechanical effects. At the same time, internal bleeding, for example, in the stomach, uterus or cavity, occurs against the background of the development of diseases or is a consequence of physiological processes, including menstruation.
In patients with a low protein norm according to the INR results and excessive blood coagulation, there is a high probability of blood clots, the development of serious complications such as thrombosis, pulmonary embolism and others. To improve the patient’s condition, the doctor recommends using an increased dose of a blood thinning drug.
Who needs to undergo an analysis without fail?
For analysis, there is a list of certain indications. The values obtained are used to judge the presence or absence of a disease. Since the technique is effective, the results obtained are reliable and allow to determine the causes of health deterioration as accurately as possible.
Indications:
- Surgery planning The prothrombin level is close to unity. The values of the indicator can be 0.7-1.3, but 0.85-1.25 is usually detected.
- Undergoing aortic valve replacement with a mechanical implant. Standard values are 2-3.
- Treatment of pulmonary embolism. Protein should be determined in an amount of 2-3.
- The need for blood thinning medication. The norm is 2-3.
- Installation of the mitral valve using a mechanical implant. Standard values range from 2.5 to 3.5.
- Preventive measures for pulmonary embolism in patients with heart disease. As in most cases, the norm is 2-3.
- Preventive effect on the body in patients with thrombosis in the event of damage to deep veins after surgery. Normative values of the indicator are determined from 2 to 3.
How often can a study be done?
After the appointment of an anticoagulant, doctors recommend that patients regularly undergo a repeat study. For patients, specific time intervals are established taking into account individual characteristics and the course of the underlying disease.
When the patient is in the hospital, the blood is examined daily. After discharge and further control of the protein level is required. It is performed every week, that is, the interval is 7 days. If it is possible to achieve stable results, the frequency of the test is reduced to once every 2-3 weeks.
The need for extraordinary analysis
Analysis is not always carried out according to plan, sometimes you have to move away from the schedule. The reasons are as follows:
- determination of blood in the composition of urine, feces, sputum or vomit;
- moving to other climatic conditions;
- long-term catarrhal disease or other pathology;
- bleeding gums;
- changes in the concomitant treatment regimen;
- the formation of hematomas and nosebleeds for no apparent reason;
- adjustments in diet or lifestyle;
- difficulties associated with stopping bleeding during cuts;
- long periods with heavy discharge;
- the formation of seals, the appearance of pain and swelling in the joints.
Where is the analysis performed?
To take the study, select one of the following options:
- Visit your local doctor. The specialist will listen to your complaints, study the anamnesis and write out a direction for analysis in the laboratory or clinic.
- Buy a device designed specifically for this purpose. It is very convenient and analysis can be done independently at home.
- Come to the therapist’s office, where there is special equipment, and go directly to the study.
The analysis is prescribed to all patients who have gaps with blood coagulation. Take it regularly according to an individually designed schedule and follow the doctor's recommendations.