Blood is the main nutrient medium of the human body. Continuously circulating in it and supplying the cells with oxygen and all the necessary metabolites, it performs its main functions. In addition, the blood also contains protection against the introduction of many pathogens of infectious diseases, as well as preventing bleeding in the event of damage to any vessel. This is ensured by a special coagulation system consisting of a complex set of proteins. Now let us dwell on this in more detail.
The structure of hemostasis
It is worth finding out what the hemostatic system is. It consists of two components antagonistic to each other - coagulation and anticoagulation. But at the same time, they harmoniously complement each other so that the blood does not change its quality parameters and is able to nourish other tissues. The first gets an advantage in bleeding, when it is necessary to create a blood clot to obstruct an open lumen in the vessel wall. The second is activated immediately after the work of the first, thereby preventing increased coagulability and the development of thrombosis with such severe consequences as stroke and myocardial infarction.
Therefore, for many diseases, a general blood test is taken . Blood coagulation and its bacterial culture are the goals of this study. Based on his data, you can make the correct diagnosis and prescribe the appropriate treatment.
Components in a General Blood Test
Among the components of the coagulation system, both cells and proteins occupy an important place. First of all, these are platelets, which, in addition to their main function, also provide nutrition to the endothelium, lining all blood vessels from the inside. Their number can be found by passing a clinical complete blood count. Coagulability, however, depends not only on their number, but also on their quality. So, with congenital failure, the functions of these cells develop thrombocytopathies, which are difficult to detect and are characterized by multiple, difficult to stop bleeding, which can ultimately lead to death of a person. Another simple component that even enters into an extended clinical blood test is the cohort time according to Lee-White. It is determined by shaking the test tube with the substrate taken until a thick, non-decaying clot appears in it.
Characteristic factors
The proteins that make up the coagulation system are called thirteen factors. Their uniqueness lies in the fact that they are normally in an inactive state until there is a reason for their activity, as well as in the complex chain of their launch, in which they themselves act as catalysts for the following reactions. Thus, this system remains relatively isolated. The characteristic of the quality of their work is included in a narrow blood test - “blood coagulation”, or “coagulogram”. It includes a limited number of parameters, but a doctor who knows about them can pinpoint the cause of hemostasis and even the underlying disease. Thus, the decoding of a blood test “coagulability” occupies an important place in the clinical experience of each specialist, and therefore we will dwell on it in more detail.
Key indicators of the coagulation system
So, the following key concepts are included in this study.
- The first one . D-dimer is an important indicator of thrombosis, and therefore is used for early diagnosis of thrombosis. In pregnant women, it is found in an increased amount (3-4 times) by the end of the gestation period, but this is a variant of the norm. Detection of it in a much higher concentration already indicates a pathological course of pregnancy. In addition, its increase is detected in diseases such as rheumatoid arthritis, hemorrhagic complications, severe infections.
- The second concept . Prothrombin time with the parallel calculation of the INR and PTI (prothrombin index) characterizes the state of the blood coagulation system and is measured by coagulation and by the formulas. It is determined both for the assessment of hemostasis, and during therapy with indirect anticoagulants.
- The third. Fibrinogen is a complex protein. It is the skeleton for the formation of a blood clot - a blood clot. Its increase is accompanied by hepatitis, kidney disease, myocardial infarction, radiation sickness, and malignant tumors. However, it is also observed during pregnancy, during menstruation, as well as when taking oral contraceptives with a predominant estrogen component.
Coagulation Indices
- The fourth concept . Lupus coagulant is a group of antibodies to their own platelets, which is a manifestation of a severe autoimmune process. More often found in pathology in pregnancy, i.e., with gestosis. Its presence explains their severe hemodynamic disturbances - edema, blood pressure, high probability of spontaneous miscarriage. Therefore, a blood coagulation test is performed for all pregnant women to exclude this parameter.
- Fifth. Antithrombin-3, in contrast, is a protein of the anticoagulant system and an inhibitor of thrombin. If the patient passes a blood coagulation test and receives a decrease in this component in the results, then this indicates a risk of thrombosis. Also, the determination of antithrombin-3 is important for monitoring patients who have been receiving anticoagulant drugs for a long time (TromboASS, Cardiomagnyl, and Clopidogrel drugs).
To summarize
In addition to the above, there is an APTT indicator that most clearly reflects a sufficient / deficient number of coagulation factors. Therefore, its determination is most important for hemophilia of various genesis, von Willebrand disease, in the presence of coagulation inhibitors or excessive intake of anticoagulants. It should be noted that a blood coagulation test can only be done according to indications. However, if you suspect a violation of the hemostatic system, you must immediately consult a doctor.