Coagulation: what is this analysis?
For the diagnosis of various diseases related to blood vorachivaetsya use koagulogrammou. What is it? This is a special blood test, the results of which speak about the speed of it clotting. The study was conducted with pregnant women, patients with bleeding and in some other cases.
Why appoint koagulogrammou?
Indications for this test set, since the clotting of blood affects many processes in the body. However, it is often necessary for coagulation:
- examination of the body as a whole;
- study of the hemostatic system of the patient;
- preparation for surgical procedures, childbirth or caesarean section;
- the diagnosis of gestosis (complications late in the third trimester of pregnancy);
- control treatment with drugs that affect blood clotting;
- examination of the patient for haemorrhagic disease (disease in which there is increased bleeding);
- varicose veins in the legs;
- exclude the possibility of thrombosis when there is such a risk (e.g., ischemic heart disease);
- the diagnosis of «DIC» (an acquired disease in which disrupted the system of blood clotting);
- diagnosis of patients taking hormonal preparations including oral contraceptives;
- examination of the patient with cirrhosis of the liver;
- diagnosis of acute inflammation;
- the pronouncement of the diagnosis and treatment for thrombosis different vessels.
Coagulation in pregnancy
We should also mention the case when the study is prescribed to patients who bears a child. Coagulation — this is a mandatory survey when planning for childbirth or caesarean section. Analysis administered 1 time per trimester, in some cases more often, for example, if the patient has the disease from the above list or she has a negative RH factor. These factors can significantly affect the course of pregnancy, health and even the life of the baby. If you do not conduct a study in time and to identify problems, expectant mother can be miscarriage, premature birth, and fetal — pathology of the brain.
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Features of the study
Offer to hold koagulogrammou usually in the morning, as the analysis after not eating for 8 – 12 hours. In addition, the day before the «date X» should not eat spicy, fatty or smoked food and drink alcohol. Temporarily suspend therapy with anticoagulants both direct and not direct action, their effect can significantly distort the results of analysis (in case of impossibility of stopping treatment warning assistant). Koagulogrammou can’t smoke.
Sampling of biological fluid occurs via dry and sterile syringe or system for vacuum blood sampling. It is important that the needle with a wide lumen, and a tourniquet was not used. It is impossible to use the method of atraumatic vein puncture — this can affect the results. Doctor gives blood 2 tubes, but sends second diagnostics only with the special coagulant (usually sodium citrate). Evaluation of the results usually takes no more than 2 days. The exact date of the diagnosis depends on the availability of reagents in the laboratory, from its workload, the skill of the doctor, from the present technology and other factors.
A little bit about the mechanisms of blood clotting
Before discussing, what are the coagulation parameters were in normal, it is necessary to better understand the system of blood clotting. When the damaged wall of the blood vessel releases thromboplastin, which is the «trigger». Then aktiviziruyutsya special proteins responsible for the formation of a thrombus where there is damage in a healthy person they always have in the blood. A natural component of blood, makes the thrombin inactive protein fibrinogen to turn into active fibrin. He becomes the basis of a bunch of «confusing» in itself the formed elements of blood and not allowing them to go outside. Platelets reduce clot, forming a thrombus is formed, which is a complete defense. Anticoagulation system, by contrast, protects people from unnecessary blood clots. If a person is healthy, these processes complement each other, maintaining the normal condition of the body and blood clotting when needed.
The norm in coagulogram
There are a large number of coagulation that may be interested in attending. What is important for the patient depends on why the appointed study.
- Activated partial thromboplastin time (APTT) is a measure that defines the deadline for the formation of a blood clot. He describes the system of blood clotting and is one of the most sensitive and accurate data. The norm are 24 to 35 seconds, but in pregnant women is considered normal and indicators 17 – 20.
- Fibrinogen, which has already been discussed above, is produced in the liver. And because of it formed the main part of the clot of blood, then a clot forms. Fibrinogen also affects the erythrocyte, being one of the most important proteins in human blood. Its concentration is 2 – 4 grams per liter of biological fluid.
- Thrombin time, unlike the first indicator, is a more narrow concept. It evaluates the speed of the last stage of coagulation is the conversion of fibrinogen to active fibrin. This indicator is affected by the number and characteristics of fibrinogen, presence of blood thinners and other factors. Thrombin time-characterizes the anticoagulant activity of the blood and helps to detect dysfibrinogenemia — hereditary disease in which disrupted the function of fibrinogen. This speed in 2 – 3 times lower than the APTT and is 11 – 18 seconds.
- Prothrombin is measured in a percentage, allowing you to evaluate the performance of the prothrombin complex of blood compared to protrombinovy time, which were discussed above. Considered normal indicators from 78 to 142%.
- Lupus anticoagulant — antibodies to the outer shell of formed elements of blood — platelets. In normal person, they are not produced, and is characteristic of autoimmune diseases, pathologies of pregnancy, etc. is Particularly dangerous in the presence of a lupus anticoagulant pregnancy treatment — it threatened spontaneous abortion, infarction (necrosis of the segment) of the placenta, and even the death of a child.
- A protein called antithrombin III anticoagulant system. He, on the contrary, inhibits the process of clot formation and clot formation. The concentration of antithrombin, which in norm is 71 – 115%, diagnosed by the inhibition (the so-called binding of thrombin in the blood sample). The lack of protein leads to thrombosis.
- D-dimer characterizes the process of clot formation and dissolution of fibrin. In healthy patients, this figure rises to over 248 ng/ml. same as antithrombin, D-dimer to diagnose thrombosis. It should be noted that in pregnant women, this figure may rise significantly (by the end of the third trimester, even in 3 – 4 times). However, you should ensure that D-dimer did not become even greater in this case, there is a risk of gestosis, diabetes and kidney conditions.
- The platelets are called the formed elements of blood that provide hemostasis (maintaining the liquid state of body fluids). In contrast to fibrinogen, the platelets are synthesized in bone marrow. In a healthy person is observed 150 000 — 450 000 cells per ál of blood. A small reduction (up to 20,000) is observed during pregnancy. If the indicator continues to fall, you need to think about the wrong education system platelet destruction or imbalance of the patient’s diet, malnutrition. The number of elements in the blood increases in DIC.
Remember that determine what shows coagulation of blood, is this the norm or pathology – can only be attending physician with the necessary expertise. Depending on patient characteristics, indicators can significantly differ from those described above. Do not self-medicate!
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