Quite often, in the process of diagnosing a particular disease, doctors recommend that their patients undergo a study called hemostasiogram. What it is? What can be learned using this test? How and when do you need to be tested? How much does the procedure cost? The answers to these questions are sought by each person who is faced with the need to undergo a similar study.
Hemostasiogram: what is it?
Modern diagnostics has in its arsenal a lot of different tests and examinations with which you can establish an accurate diagnosis. One of the important studies is a hemostasiogram, which is also a coagulogram. What kind of analysis is this and in what cases should it be done?
This is an important study that allows you to study the processes of blood coagulation. The hemostasis system performs two functions at once: on the one hand, it maintains the blood inside the vessels in a liquid state, and on the other hand, it responds to vascular damage and triggers the mechanisms to stop bleeding. Naturally, a malfunction of such a system leads to dangerous complications, which for some patients end fatally.
A coagulogram helps to determine the presence of failures in a similar scheme. What kind of analysis is this, we figured it out. Now you need to consider other information about the study.
In what cases recommend testing?
Of course, in the ideal case, from time to time, each person would have to donate blood for analysis of coagulation processes. But at present, this testing is carried out in the presence of certain indications:
- Severe liver disease.
- Diseases of the endocrine system (hormone levels also affect blood coagulation).
- Pathologies of the urinary and cardiovascular system.
- The presence of some autoimmune diseases in a patient.
- Regular nosebleeds, severe bleeding gums.
- Phlebeurysm.
- The patient has bad habits, chronic alcoholism.
- The tendency to form large bruises, even with the slightest bruises.
- Bad results from previous coagulograms.
- A hemostasiogram is extremely important during pregnancy. It is prescribed for women who are diagnosed with uterine hypertonicity, gestosis, intrauterine growth retardation and other complications. Also indications are multiple pregnancies, the presence of a history of miscarriages.
- The study is also carried out before surgery, because a violation of blood coagulation can lead to the death of the patient during surgery.
Extended and conventional hemostasiogram: what is the difference?
In most cases, patients are prescribed a standard analysis, which includes the determination of indicators such as thrombin and prothrombin time, the level of fibrinogen and prothrombin. The specialist also calculates the number of platelets in the peripheral blood, determines INR and RKMF (soluble complexes of fibrin monomers).
Sometimes the so-called expanded hemostasiogram is also performed . What it is? In fact, this is the same study, but in addition to the above indicators, the laboratory assistant determines some other parameters, including antithrombin III, lupus anticoagulant and D-dimer. Since the analysis is more time-consuming, its cost in the clinic is slightly higher.
Test preparation
In order for the coagulogram (hemostasiogram) to be reliable, some preparation is necessary. Samples are taken on an empty stomach. Moreover, patients are not recommended to eat within 8-12 hours before the procedure. Only drink clean, non-carbonated water.
In addition, on the day before the test, you need to limit physical activity, avoid stress, have a good rest and sleep. The use of alcohol and certain medications (in particular, aspirin, which is known to thin the blood) should be abandoned at least a week before the procedure. If there is an urgent need to take any medications during this period, their list should be provided to the attending physician, since many drugs affect the results of the analysis.
Women are not recommended to take tests during menstruation. During this period, the body loses a certain amount of blood, which can cause a short-term increase in its coagulability and, accordingly, distort the real data on homeostasis.
How to pass the analysis?
There is an important question for each patient who is prescribed a hemostasiogram: how to get tested? It was already mentioned that the delivery of samples should be performed on an empty stomach, which means that the procedure is prescribed for the morning hours (usually from 8 to 11 in the morning).
Blood is taken from a vein for a hemostasiogram. The procedure is standard - with the help of a sterile syringe, the laboratory assistant takes the required amount of blood (takes several minutes). After that, the samples are sent for laboratory research. By the way, in most cases, the results of the analysis are ready after 2-3 hours after delivery.
Where are such studies conducted?
Where to make a hemostasiogram? A similar procedure is carried out in almost every clinic and medical center, so there will be no problems finding a test point. On the other hand, it’s better to carefully read the reviews about the work of a particular laboratory, because the further course of therapy depends on the results of the study.
Hemostasiogram: interpretation of indicators
After the analysis, the patient, as a rule, receives a form in the form of a table, which contains the parameters found during the study. The results should be shown to the specialist as soon as possible, because he can determine what your hemostasiogram testifies to. Deciphering the indicators is a difficult matter; the patient alone cannot figure out all the figures. As a rule, the following indicators are recorded on the form:
- APTT - activated partial partial thromboplastin time - allows you to evaluate the work of the internal blood coagulation pathway.
- Prothrombin time - this indicator allows you to evaluate the external pathway of blood coagulation (this is the time during which plasma begins to coagulate when tissue factors, prothrombin and calcium are added; as a rule, it is 15-17 s).
- INR (international normalized ratio) - during the study, the laboratory assistant compares the processes of blood coagulation of the patient with a special plasma, the indicators of which correspond to international standards.
- The level of fibrinogen, a protein that, when the coagulation process starts, turns into fibrin (its concentration is 2-4 g / l).
- Thrombin time is the length of time that is necessary for the formation of fibrin and fibrinogen (normal - from 11 to 18 s).
- The number of platelets in the blood (normally it is from 150 to 400 thousand cells per 1 μl).
- The presence of a D-dimer (this indicator should not exceed 248 ng / mg).
Prothrombin time
A correctly conducted study helps the doctor to find out about the specific protein prothrombin in the patient’s blood. This is an important component of the blood coagulation process, since it precedes the substance, which triggers the formation of a blood clot and, accordingly, the stopping of bleeding. This protein is formed in the human liver (vitamin K is required for its synthesis). Deviations in prothrombin levels may indicate impaired liver and digestive tract.
Prothrombin time is another important indicator that makes it possible to determine a hemostasiogram. What it is? In fact, this is the length of time for which the blood "reacts" to the wound and produces a firbin clot. In a healthy person, this process takes 10-18 s.
Quite often, during the study, the laboratory assistant not only measures the time, but also determines the prothrombin index. Normally, this indicator is at least 93%. A decrease in this indicator indicates impaired liver function. Sometimes it is associated with a violation of the digestive tract, a deficiency of vitamins K, the use of a large number of diuretics or preparations containing acetylsalicylic acid. It also indicates a risk of bleeding. But an increase in the index to 106% and higher indicates a tendency for blood to form blood clots.
Thrombin time: normal and deviations
This is another extremely important factor that makes it possible to determine a hemostasiogram. What it is? Thrombin time is the time it takes for an inactive fibrinogen to turn into fibrin. In a healthy person, this indicator is 15-18 s.
In addition, during a laboratory study, it is necessary to determine the content of fibrinogen in the blood. The normal content of this protein in the blood is 2-4 g / l. It is worth saying that the level of fibrinogen can sometimes increase. This is observed, for example, in the last month of pregnancy, as well as after a stroke, heart attack, in the presence of burns, thyroid disease, prolonged use of hormonal contraceptives. In such cases, an increase in fibrinogen to 6 g / l is considered normal.
A strong decrease in the amount of this protein is observed against the background of severe liver diseases (including hepatitis and cirrhosis), a deficiency of B vitamins and ascorbic acid in the body.
One of the most important parameters in this test is APTT. This is the time during which a blood clot can form when calcium chloride is added to the plasma. Normally, it takes about 30-40 seconds. This indicator most accurately describes the functioning of the hemostatic system.
Blood clotting disorders
Naturally, there are a huge number of pathologies that this analysis can point to. A hemostasiogram helps to identify some important bleeding disorders:
- Hypocoagulation is a condition that is accompanied by a decrease in the rate of blood coagulation, which is fraught with frequent bleeding (sometimes even from a small scratch).
- Hypercoagulation is a pathology characterized by an increase in the degree of blood coagulation. She folds even in the absence of injuries and injuries.
- Thrombophilia is a condition in which the tendency to form blood clots increases. Naturally, such a pathology is very dangerous and in the absence of therapy can lead to death.
Why do research during pregnancy?
During pregnancy, this analysis is very important, as it helps to diagnose complications and possible risks in time. For example, the doctor can determine if the baby receives enough oxygen and nutrients along with the blood, whether there is a likelihood of clogging of blood vessels or massive bleeding during childbirth. As a rule, the analysis is carried out immediately after the patient is registered in the hospital, and then at the 22nd and 26th week.
How much does the analysis cost?
Naturally, for many patients an important point is the cost of this or that examination. So how much does the hemostasiogram cost? The price, of course, depends on many factors. For example, you need to take into account the qualifications of a specialist and the financial policy of a medical center, the services of which you decide to use. The cost of basic research varies widely - from 400 to 1300 rubles.
An expanded hemostasiogram, of course, costs more - about 3000-4000 rubles. Of course, the numbers in this case are not too small. But you need to understand that the results of the tests will help the doctor in time to correctly diagnose the disease. By the way, in some clinics this study is free.
The results and their reliability depend on the qualifications and experience of the laboratory assistant who conducts the study. Therefore, you need to carefully approach the choice of a specialist and a medical center. Remember that only a doctor can correctly decipher the test results and assess the condition of the patient's body.