What is called a blood coagulogram, and what is its diagnostic significance?
What is a coagulogram, and what is the diagnostic significance of this study? A similar question is often asked by those who first encounter such a study of blood. A coagulogram or hemostasiogram is performed in order to determine the different characteristics of the patient's blood coagulation.
First, the coagulogram is carried out in the usual general form. If pathology is found in this study, the doctors recommend that you submit a second analysis, which has already been expanded. In expanded form, the blood parameters are described in more detail. A coagulogram of blood is prescribed for people with cardiovascular diseases, those who are preparing for surgery or during pregnancy.
The analysis of "coagulogram" is sometimes called a haemostasiogram or coagulation hemostasis. It helps to determine whether the blood clotting process is proceeding correctly, because this function is considered protective for the body.
When the vessel is injured, blood by its own forces should increase the number of platelets at the site of the rupture, which leads to the stopping of bleeding. If this function is broken, and there is an increased hyperaggregation of platelets, there is a high risk of thrombosis. If coagulability, on the contrary, is reduced, the patient often has to face bleeding. The result of the haemostasiogram and coagulogram is deciphered only by highly qualified laboratory technicians.
- For what and when to donate blood to a coagulogram?
- How to donate blood correctly?
- How and why to prepare for analysis?
- Basic and additional indicators of blood coagulology analysis
- Characteristics of indicators
- Clotting time
- Prothrombin time (PT)
- Plasma tolerance to heparin
- Why is coagulogram important for pregnant women?
- How much do I pay for the analysis?
For what and when to donate blood to a coagulogram?
Blood on the coagulogram doctors recommend taking in the following cases:
- Before the forthcoming operation. When an operation is performed, the risk of bleeding is high enough. To minimize it, you need to donate blood for coagulation testing.
- In the period of bearing a child. Women in the position are checked for blood coagulation 1 time per trimester. If during this period fetoplacental insufficiency or gestosis is detected, then the frequency of testing for a coagulogram of the blood will increase.
- If there are pathologies of blood vessels. Coagulogram indices are especially important if there is a diagnosis of vascular thrombosis or varicose veins.
- Cardiovascular diseases. Hemostasiogram or coagulogram must be performed with IHD, myocardial infarction and stroke, with thrombocytosis.
- When taking anticoagulants. If the patient has problems with such a blood indicator, then taking anticoagulants should cancel or change the dosage.
- Before prescribing drugs that are based on acetylsalicylic acid.
- Before and during the reception of contraceptive drugs. To surrender a blood in this case it is necessary 1 time in every three months.
- In the process of treatment with leeches (hirudotherapy). Due to a coagulogram of blood, doctors manage to prevent the development of hemorrhage.
- If the DIC-syndrome is diagnosed.
- With chronic kidney disease. It is especially important to pass the analysis on the coagulogram to people with cirrhosis of the liver.
- If the body has a long, acute inflammatory process.
- Any violations in the system of hemostasis in adults and children are considered a direct indication for this analysis.
How to donate blood correctly?
Where do they take the blood for analysis? A common and expanded coagulogram is done only with the slaughter of venous blood.
To do this, the lab technicians perform the following actions:
- the injection site of the syringe is treated with an aseptic solution;
- Blood sampling is performed exclusively by a sterile syringe having a wide lumen;
- In the procedure, do not use a tourniquet, as this may affect blood counts;
- 2 tubes of material are collected, but only the second is sent for analysis (it must contain sodium citrate);
- The puncture should be non-traumatic, since in the presence of injuries it is possible to get a tissue thromboplastin into the tube;
- place puncture for a while holding cotton wool.
An important role in obtaining true data is played by the preparation for this procedure.
How and why to prepare for analysis?
Indicators of the coagulogram in the expanded analysis are recorded in a table. The total number of indicators is 13, so it is important to carefully prepare for this analysis.
Rules for preparing for analysis:
- analysis is given on an empty stomach (you can not consume food 12 hours before the day of taking the material);
- You can not pre-eat fatty, too salty and fried foods;
- you can drink water;
- you can not drink tea, coffee, juices;
- it is contraindicated for a few days before the procedure to drink alcoholic beverages;
- it is impossible to smoke 2-3 hours before taking the material;
- 30-40 minutes before the procedure, it is recommended to drink 1 glass of water;
- it is shown to reduce the physical activity the day before, minimize the stress factor;
- warn the doctor about taking anticoagulants, which affect the coagulation of blood (if you can not cancel, then it is worth telling the lab technician);
- if the patient is afraid of the type of blood, then it is worth mentioning to the laboratory assistant (taking the material in this case is carried out in the supine position).
Basic and additional indicators of blood coagulology analysis
The interpretation of indicators is based on the diagnosis of basic and additional analysis parameters. The basic ones are included in the general coagulogram, and the detailed analysis takes into account both types of parameters.
The basic characteristics of blood clotting include:
- Fibrinogen. It is a protein that is produced by the liver. In some situations, fibrinogen can be converted to fibrin protein. Fibrin is the basis for the formation of thrombi. A healthy human fibrinogen should not be more than 2-4 g / l.
- PTI, PTV. The norm of PTI is 93-107%.
- APTTV. The norm is 50-70 seconds. At deviation from it sharply raises probability of strong hemorrhage at a bleeding.
- Thrombin time. The norm is 15-18 seconds. Helps determine the period of transformation of fibrinogen into fibrin. In case of a decrease in the index, we can say that there is an excess of fibrinogen in the blood.
Additional analysis parameters include:
- Prothin C;
- plasma tolerance to heparin;
- lupus anticoagulant.
When a patient knows what is included in the coagulogram, it is easier for him to understand what format of analysis has been done - general or deployed.
Characteristics of indicators
The time indicator is normal, if in the analysis this process takes place in 5-10 minutes. If the indicator is lower or higher than the norm, then it is worth looking for the cause. Excess coagulation time is due to insufficient amount of enzyme prothrombinase, deficiency of prothrombin and fibrinogen. Sometimes this condition is noted with a deficiency of vitamin C and as a result of prolonged intake of oral contraceptives.
PTI is the difference between the control blood and the patient's blood. Control blood is called a healthy person's blood. This analysis parameter helps to determine how healthy the patient's liver is..
Important! During pregnancy, RTI can increase, which should not frighten a woman. Such a change is considered the norm..
When the index is higher than normal, this may indicate a high risk of blood clots.
Still such results can be received at women who accept oral contraceptives. On the contrary, fixing the index will be below the norm in case of frequent bleeding. For the coagulogram indicator to be normal, it is important to eat foods rich in vitamin K.
Prothrombin time (PT)
This parameter determines the time of transformation of fibrinogen into fibrin. In the blood, the norm is 15-18 seconds. If the gap lengthens, it can talk about the development of severe kidney failure, dysbiosis, beriberi. If a person uses heparin during treatment, the deficit of fibrinogen can be considered a serious pathology.
A blood test for hemostasis is impossible without this indicator, as it shows the process of modifying plasma recalcification taking into account the addition of phospholipids. Phospholipid is a solution of cephalic. It is this indicator doctors consider the most vulnerable. The APTTV rate is 38-55 seconds. A deviation from the norm in the lower direction may indicate a high risk of thrombosis. An increase in the rate may be observed in people whose treatment was based on heparin.
The coagulogram chart necessarily includes a fibrinogen index or thrombotest. The norm of fibrinogen is -1, μmol / l. If you recalculate to liters, the rate will be 2-3 g / l.
If there is a decrease in fibrinolytic activity of the blood, this indicates the congenital diseases, the development of liver pathologies. Genetic disease with this feature is called fibrinogenemia.
The growth of the indicator is noted with the development of neoplasms in the body, infectious diseases, thrombosis, hypothyroidism of the thyroid gland, after childbirth, and operations. In neonates the norm of fibrinogen is 5-3 g / l., Which shows the total health of the child. Thrombotesture should normally be at grade 4-5.
Soluble fibrin-monomer complexes help to determine changes in the molecular integrity of fibrin during the period when plasmin and thrombin act on it. The upper limit of the norm of this indicator is 4 mg / 100 ml of blood. It is this indicator that many laboratory assistants, when decrypting results, are mistaken for the marker responsible for the clotting property. Various abnormalities directly depend on the amount of fibrinogen.
Plasma tolerance to heparin
To determine fibrinolytic activity, heparin is injected into the patient's blood. The time required to form a clot is called plasma tolerance to heparin. Normal indices vary within 7-15 minutes. You can talk about reducing the indicator if the clotting time is delayed to half an hour. This reaction occurs with liver disease. With rapid tolerance, less than 7 minutes, doctors diagnose hypercoagulation. This condition is typical for pregnant women. Another such feature of plasma tolerance is seen in people with neoplasms, during the postoperative period and in the development of serious pathologies of the cardiovascular system.
The coagulogram always has high demands on the accuracy of the results, since the slightest changes in the properties of the blood can already in the early stages help to diagnose the disease. Often the test for DIC-syndrome is carried out by pregnant women, in time to diagnose disseminated intravascular coagulation. This condition manifests itself in the form of activation of fibrinolysin. If this change is fixed, then the woman during pregnancy has a dramatic increase in the risk of placental peeling, embolism with amniotic fluid and endometritis.
Why is coagulogram important for pregnant women?
When a woman learns about pregnancy, it is important to be registered in a women's consultation on time. The attending physician will prescribe the passage of various examinations, the delivery of tests. All this is done to timely diagnose various diseases not only the mother, but also the child in her womb.
One of the important indicators is a coagulogram, as it will help determine how much the mother's body is ready for labor. In early terms, blood coagulability may be below normal. This state is normal, because over time this figure will rise. In the final trimester, the body increases the coagulation purposefully. So he prepares for possible blood loss during childbirth.
This analysis helps prevent premature birth or miscarriage. Such situations can develop due to disrupted hemostasis of the mother, the cause of which is the process of thrombosis.
How much do I pay for the analysis?
The professional decoding of the coagulogram determines the patient's health, so this study is conducted in a medical institution that has all the relevant reagents for analysis.
Evaluation of blood aggregation is carried out at the highest level in professional clinics. The cost of this procedure in the Moscow clinics: a general analysis - from 700 rubles, a detailed analysis - about 3000 rubles.
A pregnant woman, in order to know what tests to take, first of all you need to become registered. The lead doctor should send a minimum of 3 times for the entire period of pregnancy to the blood coagulogram analysis.
Coagulogram in children is the same as for adults. Parents should conduct this analysis if the child often has nosebleeds, or he can not stop the blood for a long time because of the injury. Any suspicions of hemophilia are also a pretext to conduct this analysis... .