When is the best time to take a coagulogram test? Useful tips: how to properly donate blood for a coagulogram. We are on social media networks

Preparing for a coagulogram does not require much time. The fact is that the procedure is carried out in the morning on an empty stomach. It is advisable that at least 8 hours have passed since the last meal. During this period you are allowed to drink water.

If a person is taking medications that can affect blood clotting, it is necessary to inform the attending physician. Otherwise, the analysis may not be reliable and, moreover, may significantly harm the person.

No other preparation measures are required. It is important simply not to eat before the procedure and not to take special medications. This will allow you to get truly correct and reliable results.

A coagulogram is a procedure that every person may need. Therefore, it is advisable to carry it out correctly and treat it with full responsibility. A lot can depend on its result, especially if the date of birth or surgery is approaching. A coagulogram is performed in almost every clinic.

Is it possible to eat before a coagulogram?

Many people are interested in the question: is it possible to eat before a coagulogram? This procedure is performed exclusively on an empty stomach. Therefore, any food intake is prohibited. The only thing allowed is just drinking water.

It is advisable that at least 8 hours have passed since the last meal. The fact is that the procedure is serious and thanks to it you can determine the properties of blood. Auxiliary components, including sugar, found in food can significantly worsen the result. That is why it is not recommended to eat it.

In addition, if a person takes any medications You should tell your doctor about this. After all, many medications can affect blood clotting. It is advisable to immediately discuss all the nuances so that the procedure goes smoothly and gives high-quality results.

As for drinks, it should be exclusively water. Coffee and tea are prohibited. A coagulogram is performed on an empty stomach in the morning.

How to take a coagulogram?

Do you know how to take a coagulogram? Before you go to this procedure, you should refrain from eating. It is advisable that the interval be at least 8-12 hours.

You cannot drink coffee, tea, juice or alcoholic drinks. If you really want to eat, it is better to drink plain water. After the procedure, the person will be able to eat any food. Before the analysis itself, it is advisable to provide full list medications that are taken and used in the last 2-3 days.

At the very moment of surrender, it is necessary for the person to be completely calm, not nervous or worried. The point is that ordinary muscle tension can have a significant impact on the results. In order to obtain more accurate parameters, you need to drink a glass of cool water before the analysis. The procedure is painless and completed quite quickly. A coagulogram is a mandatory test that must be done before childbirth or surgery.

How to take a coagulogram correctly?

Not many people know how to take a coagulogram correctly. In essence, the procedure is similar to taking blood from a finger, but it is not so simple. The fact is that it is not recommended to eat before going for the test. It is advisable that at least 8-12 hours have passed since the last meal. This will allow you to get truly accurate results. Many elements found in food can degrade the “reliability” of information.

If you want to eat, it’s better to just drink water and be patient. That is why the procedure is carried out in the morning. As soon as a person wakes up, he should immediately visit the clinic.

The procedure itself is painless and carried out quite quickly. The main thing is not to eat or drink certain drinks, in this case you will be able to achieve an accurate result. A coagulogram is mandatory if in the near future a person will have to lose a small amount of blood as a result of childbirth or surgery.

Coagulogram during pregnancy

Coagulogram when planning pregnancy

A coagulogram is important when planning pregnancy, because the course of the process in general depends on it. Some indicators may vary throughout the entire period of bearing a child, and this is quite normal.

But, despite this, a decrease or increase in the level of elements may indicate the presence of deviations. Normal indicators are very important. After all, during childbirth, a woman loses a small amount of blood. In this matter, a lot depends on how quickly it collapses.

It should be understood that increased clotting activity can lead to placental abruption and cause severe bleeding. Naturally, there is also a risk of developing blood clots in the placental vessels, which subsequently leads to fetal hypoxia. Therefore, coagulogram studies during pregnancy planning and during pregnancy are important. This will avoid many problems and save the baby. A coagulogram should be carried out constantly, this will allow you to monitor changes in blood clotting.

Coagulogram during menstruation

A coagulogram during menstruation is not able to give clear results. The fact is that during this period the blood is diluted and it is not possible to test its clotting abilities. Therefore, to carry out the procedure, it is advisable to wait until the end critical days, but also do not get tested right away.

Naturally, such a question can only be clarified with a doctor. He will give some recommendations and advise when it is best to seek help and conduct the necessary analysis. In general, the procedure is not performed during menstruation.

During this period, the body, on the contrary, is interested in excreting excess blood from the uterus, so coagulation is somehow impaired. After critical days everything comes to a head full normal, and the woman may well get tested. Again, it is also not worth carrying out the procedure just before your period; the body is preparing for the withdrawal process and the blood gradually thins out. In this case, the coagulogram will be unreliable and will have to be taken again.

Coagulogram in children

A coagulogram in children determines the capabilities of the blood regarding the clotting process. This is carried out mainly if hemophilia is suspected. This analysis They don’t do it that often for children. This is necessary only before surgery, especially if it is serious.

True, in many cases people turn to this research for help even when cutting out adenoids or tonsils. This is done to reassure oneself and confirm the fact that the child’s blood clots well.

The fact is that even minor intervention can lead to serious bleeding. It will not be so easy to stop and the child may lose a large amount of blood. At increased rates Surgery is not recommended. This can lead to blockage of blood vessels, which is extremely unacceptable and can lead to serious problems with health. Quite often, a coagulogram is performed on children if there is a suspicion of blood pathology.

Coagulogram in newborns

A coagulogram in newborns is performed to exclude the presence of any blood pathologies. Everything happens on a general basis. The baby's blood is taken and examined, and based on the data obtained, certain results are made. It is enough to simply compare the final figures with acceptable standards.

Blood pathologies are not so rare, so this procedure is necessary. Naturally, in isolated cases there are times when the blood is not able to clot at all. In this case, everything ends in death, because this process cannot be stopped in any way.

In some cases, a coagulogram is performed before surgery. Newborns also undergo surgery to remove certain pathologies. Today, a coagulogram is a very common analysis that is performed when planning any surgical intervention. This will allow you to avoid all sorts of negative consequences during the “procedure”.

Decoding the coagulogram in children

Decoding a coagulogram in children is not particularly different from the norms given for adults. Usually, after the analysis, all the obtained indicators are summarized in a table. Using these data, you can determine the presence of certain deviations. It is enough to simply compare the data obtained with the norms. True, there are also cases when it is difficult for doctors themselves to understand the final results.

This may be due to the presence of pathologies or other negative processes in the body. Basically, the standards fluctuate in the following ranges: APTT – 25-37 sec; Fibrinogen – up to 6.5 g/l; Lupus anticoagulant – must be absent; Platelets – 131-402 thousand/µl; Prothrombin – 78-142%; Thrombin time – 18-25 s; D-dimer – 33-726 ng/ml; Antithrombin III – 70-115%.

There should be no other numbers. More precisely, they may be, but this indicates the presence of pathologies. A coagulogram shows the capabilities of the blood regarding the clotting process and, if it deviates from the norm, shows the presence of unfavorable processes in the body.

Coagulogram for myocardial infarction

Coagulogram for myocardial infarction is one of critical analyzes. Thanks to it, you can determine blood clotting indicators. It is important due to the risk of developing DIC syndrome. It is characterized by blood leaking through the vessels. This is considered one of the most severe complications of myocardial infarction.

This analysis must be carried out without fail. Based on the results, it is possible to determine deviations regarding blood clotting and draw certain conclusions. It is very important! Because a heart attack can cause serious complications on blood vessels.

It is difficult to say clearly what the indicators will be; in most cases it is purely individual. But any deviation of the “elements” indicates the presence of a pathology that needs to be combated. Any deviations are especially dangerous if there are problems with the cardiovascular system. The coagulogram may vary depending on what work is done to eliminate blood clotting problems.

Coagulogram indicators

Coagulogram indicators allow you to accurately assess the result. So, in order to decipher the results of the procedure, you need to know what indicators are included in it. So these are APTT, Fibrinogen, Lupus Coagulant, Platelets, Prothrombin, TV, D-Dimer and Antithrombin III.

APTT is the time it takes for blood to clot. Any deviations from a fixed norm may indicate the development of complications. In some cases, this indicates disseminated intravascular coagulation.

Fibrinogen is a specific protein, which is based on a component of a blood clot formed during blood clotting.

Lupus coagulant is a group of specific antibodies. A person should not have this indicator at all, but if it is still present, then there are problems in the body. It is likely that these are autoimmune diseases.

Platelets are blood cells that are produced in the bone marrow. If their rate is reduced, it means that the situation is insufficient nutrition or the presence of disseminated intravascular coagulation.

Prothrombin is a protein found in blood plasma. If necessary, it participates in the production of thrombin.

TV is thrombin time. During this period, fibrin is produced under the influence of thrombin. The slightest deviation from the norm may indicate liver pathology.

D-Dimer is an indicator that is completely responsible for the process of thrombus formation. It plays a significant role in the timely detection of thrombosis. And finally, Antithrombin III is a protein that significantly slows down blood clotting.

All these indicators are part of the analysis. A coagulogram allows you to determine which of them are normal and whether there are any deviations.

Normal coagulogram

The normal coagulogram allows you to resort to many interventions, accompanied by minor blood losses. If the results of the analysis are within acceptable ranges, then this allows you not to take risks during surgery or during childbirth.

Coagulability properties play a significant role. Especially if there is a serious “event” in the body. Only a doctor can decipher the results of the procedure. Many people try to understand on their own and, due to ignorance of the situation, cannot fully understand whether their tests are normal or not.

It is necessary to understand that results may fluctuate in one direction or another. Normal indicators are characterized by: APTT – 25-37 sec; Fibrinogen – up to 6.5 g/l; Lupus anticoagulant – must be absent; Platelets – 131-402 thousand/µl; Prothrombin – 78-142%; Thrombin time – 18-25 s; D-dimer – 33-726 ng/ml; Antithrombin III – 70-115%. If the resulting coagulogram shows far different numbers, it means that there are serious abnormalities in the body that are worth fighting.

Test tubes for coagulogram

Coagulogram tubes can be purchased separately or taken from the clinic itself. These auxiliary “devices” serve to store blood.

They are glass or plastic flasks, inside of which the “raw materials” are located. In such vacuum packaging, no unnecessary elements will enter the blood. It is enough to simply hand over the “raw materials” and place it in a test tube. The attending physician deals with this issue.

Test tubes can be different, made of different materials and different capacities. Therefore, it is better to purchase the “accessory” directly on the spot, so that no questions arise in the future. Much depends on what the blood is donated for. It is not recommended to purchase test tubes on your own; it is advisable to consult a doctor and follow his wishes. A coagulogram is a procedure that requires correct execution. That is why the first thing you should do is visit the clinic, and then start preparing for the analysis itself.

Coagulogram - what kind of analysis is this?

Many people are interested in a coagulogram, what kind of analysis is it and how to do it? It should be noted that this is a real way to determine blood clotting. Assessing the functioning of this ability is very important today. Especially if the patient is going to lose some blood. In this case, we mean childbirth or surgery.

The study of coagulation is relevant during pregnancy, when problems with the liver, blood vessels and pathologies of the immune system are detected. This analysis is often called a hemostasiogram. It includes several basic techniques. Thanks to them, it becomes possible to determine bleeding time, prothrombin time, thrombosed time, fibrinogen, lupus anticoagulant, D-dimer, antithrombin III and activated partial thromboplastin time (aPTT).

All this is necessary to determine the main indicators and abilities of the blood. This procedure is very relevant. A coagulogram allows you to prevent possible negative outcomes.

Expanded coagulogram

What is a detailed coagulogram? This is a procedure through which you can evaluate the functioning of the blood coagulation system. This is usually done for people suffering from strokes, heart attacks, oncology and other pathologies.

A detailed analysis is not done for women who are planning to give birth soon. The detailed procedure includes APTT, INR, Prothrombin Time, Thrombin Time, Fibrinogen, Antithrombin III, Protein S, Protein C, D-Dimer, Von Willebrand Factor and Lupus Anticoagulant.

All this allows you to thoroughly study the properties of blood clotting and understand whether a person can do major surgery. After all, during such interventions a large amount of blood is usually lost. If clotting is poor, this significantly worsens the situation. There are also cases when the blood is not able to clot at all, which leads to death. A coagulogram allows you to fully assess the capabilities of the blood system.

Decoding the coagulogram

The coagulogram is deciphered by the attending physician. It is not easy to independently understand what is being discussed in the analysis. To do this, you need to have some knowledge regarding this topic.

So, as a result, the following indicators can be indicated: APTT, Fibrinogen, Lupus coagulant, Platelets, Prothrombin, TV, D-Dimer and Antithrombin III.

APTT is the time it takes for blood to clot. Any deviations from the norm may indicate the development of complications or disseminated intravascular coagulation.

Fibrinogen is a specific protein that is based on a component of a blood clot; it is formed during the process of blood clotting.

Lupus coagulant is a group of specific antibodies. Normally, this indicator should not be present at all, but if it is present, then most likely we are talking about autoimmune diseases.

Platelets are blood cells that are produced in the bone marrow. Their significant decrease is usually caused by insufficient nutrition.

Prothrombin is a protein found in blood plasma. It is from this that thrombin is produced, if necessary.

TV is thrombin time. During this period, fibrin is produced under the influence of thrombin. Any deviations from the norm may indicate liver pathology.

D-Dimer is an indicator that is responsible for the process of thrombus formation. It is important for the timely detection of thrombosis.

Antithrombin III is a protein that slows blood clotting.

Based on all these indicators, the analysis is deciphered. A coagulogram is a serious procedure for which you need to prepare.

What is included in a coagulogram?

Do you know what is included in a coagulogram? This analysis includes several main indicators, by which the presence of a deviation from the norm is determined.

Thus, a regular coagulogram contains the following mandatory “elements”: APTT, Fibrinogen, Lupus coagulant, Platelets, Prothrombin, TV, D-Dimer and Antithrombin III. If we are talking about a detailed analysis, then Prothrombin time, Protein S, Protein C and von Willebrandt factor are added to this list.

Each of the indicators is responsible for its “function”. Thanks to deviations in one or another “element”, one can understand what problems exist in the human body. This is especially important before surgery or childbirth. After all, these two “types of activity” imply insignificant blood loss. The coagulogram, in turn, determines how quickly it can clot and whether there are any risks for a person. Therefore, this analysis should be taken with full responsibility.

INR

The INR coagulogram is a calculated indicator. Using it, you can view the ratio of the patient's prothrombin time to the average prothrombin time. Why is this analysis carried out?

Determining this indicator is necessary to monitor therapy with indirect anticoagulants. The last “elements” refer to drugs that promote poor clotting, such as warfarin and phenylin.

Patients on this therapy should monitor their INR at least once every 3 months. Its excessive increase can lead to a tendency to constant bleeding. A decrease in INR, on the contrary, indicates an insufficient effect of anticoagulants. At the same time, a significant risk of thrombosis remains.

This indicator must be carefully monitored. A lot can depend on this criterion. A coagulogram of this indicator is carried out not so often and is included in the extended range of procedures, which is performed upon special request.

APTT

Coagulogram APTT is activated partial thromboplastin time. Simply put, this is the length of time it takes for a blood clot to form after special reagents have been added to the plasma.

Fibrinogen

PTI

The PTI coagulogram is the prothrombin index. Under normal conditions, its value varies between 70-140%. This indicator can increase significantly in pregnant women. But this is a negative phenomenon that occurs against the background of placental abruption. Naturally, this is a normal process, but it can happen early stages. This can lead to the loss of the baby, so PTI levels must be carefully monitored.

An increase in PTI directly indicates increased blood clotting. This process is observed in thrombosis and thrombophilia. In some cases, this phenomenon occurs after long-term use of oral contraceptives.

If this indicator decreases significantly, this indicates that the person is prone to bleeding. Therefore, the issue of surgical intervention must be approached with particular seriousness. After all, the current situation can end badly. That is why a coagulogram is performed and all the necessary indicators are taken.

Dimer

RFMK

The RFMK coagulogram is intended for quantitative determination in blood plasma soluble complexes. This is exactly how RFMC is deciphered.

Soluble complexes are markers of thrombinemia during intravascular coagulation. This indicator can be determined manually.

RFMC cannot be considered a mandatory test when performing a coagulogram. It is rather carried out with an expanded definition of the existing problem. Usually, it is determined during the upcoming surgical intervention.

The main indicator is taken from donated blood. The person does not have to give anything extra. RFMK increases when blood clotting is activated. Moreover, the higher the concentration of complexes, the higher the risk of intravascular thrombus formation.

A decrease in RFMC is observed during treatment with heparin. This makes it possible to effectively identify patients who need heparin prophylaxis and heparin therapy. A coagulogram helps a lot in this case.

Prothrombin

Coagulogram prothrombin means blood clotting factor. This indicator is one of the most important. It characterizes the state of the blood coagulation system.

Any change in its quantity can lead to a clotting disorder. This may result in the impossibility of surgical intervention. After all, a person can lose a large amount of blood during this process.

Typically, an increase in prothrombin is observed with a tendency to thrombosis. Its normal value should not exceed 78-142%. A decrease in prothrombin is observed with vitamin K deficiency, as well as taking certain drugs, including warfarin and anabolic steroids. The level of blood clotting is determined quite simply. It is carried out on the basis of a general analysis - a coagulogram. It is one of the mandatory indicators. Without these data, it is impossible to predict the course of surgery or childbirth in women. That is why a coagulogram is performed immediately before the procedure itself.

Platelet aggregation

What is a coagulogram and platelet aggregation? First of all, it is worth noting the fact that platelets are the so-called ambulance body. As soon as the slightest damage to the vessel wall occurs and blood begins to flow out, a biochemical reaction of platelets is instantly produced.

Once at the site of damage, the elements are glued together and thereby stop the bleeding. Simply put, the “impulse” is blocked. This process is called platelet aggregation.

This criterion is very important when performing surgery. After all, its direct losses depend on how quickly the blood can stop. A similar process occurs during childbirth. In some cases, platelet aggregation is slow and therefore the risk of any intervention remains. It is easier when this process, on the contrary, is accelerated, although this phenomenon is considered a pathology. What “position” everything is in is determined by the coagulogram.

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Coagulogram table

The coagulogram table is the most convenient way to review the results of the analysis obtained. Usually all data is summarized in a specific table, where they are compared with standards.

As a result, all indicators should be described, depending on what analysis was carried out. With an ordinary coagulogram, the data of APTT, Fibrinogen, Lupus coagulant, Platelets, Prothrombin, TV, D-Dimer and Antithrombin III are entered into the table. With an expanded definition, Prothrombin time, Protein S, Protein C and von Willebrandt factor are also added.

Usually the table indicates the resulting indicator and the norm to which it should strive. In case of deviation, the reason is described this phenomenon. After all, each indicator depends on its own factors. Starting with the inflammatory process in the body and ending with pathological changes. Based on the data received, a decision is made regarding further actions. A coagulogram fully describes the state of blood clotting.

Before you go for testing, you should consult your doctor. He will give specific recommendations regarding the preparation process for the analysis. There is nothing complicated about this, you just have to give up food for 8-12 hours and not take certain medications. If you have any questions, you should talk to your doctor. A coagulogram is carried out in compliance with all the necessary rules, this will allow you to obtain an accurate and reliable result.

How long does it take to do a coagulogram?

Many people are interested in the question, how long does a coagulogram take? It should be noted that this is the age of advanced technology, so you won’t have to wait long. A person's blood is taken and within an hour all the results are ready.

Naturally, a lot depends on the queue for this procedure. On average, you can find out your own indicators after one hour. True, today things are not always carried out so quickly. Therefore, the maximum waiting time is one day. Usually, a coagulogram is carried out in the morning and at the same time the next day a person can receive his results.

The blood collection procedure itself takes a matter of seconds and is not difficult or painful. If necessary, not only the analysis itself is quickly carried out, but its results also become available. Usually, a coagulogram does not require rapidity and is done exclusively before interventions that are accompanied by minor blood loss.

Price of coagulogram

The price of a coagulogram directly depends on the country, city and the clinic itself. It is difficult to say for sure how much this procedure will cost. Basically, its cost does not exceed 100-250 hryvnia. Naturally, as mentioned above, it all depends on where it is held.

Modern clinics charge an appropriate amount for improved quality of work. Much depends on where the medical facility is located. If its location is closer to the capital, then the price will be appropriate. The further you go, the less, naturally.

It should also be noted that auxiliary materials also play an important role. These include special test tubes. A person can purchase it either independently or use the services of a medical institution where he is going to take the test. This also affects the price in some way. Therefore, if you are going to carry out this procedure, you should take 100-250 hryvnia with you. If we take into account the cities of the Russian Federation, then a coagulogram here costs on average 1000 rubles.

Coagulogram is a comprehensive analysis of blood clotting indicators. Studies of venous blood using the coagulometry method help assess the condition and efficiency of functioning of various parts of such blood systems as coagulation, anticoagulation and fibrinolytic.

Indicators of a coagulogram, or hemostasiogram, are studied to assess the possible risk of hyper- and hypocoagulation, respectively, increased and decreased blood clotting ability, the likelihood of blood clots or bleeding.

How to prepare for a blood clotting test

This study is carried out strictly on an empty stomach, with a break after the last meal of at least 12 hours. At the last meal, it is recommended to exclude spicy, fatty, canned foods with a lot of spices from the diet. As for drinks, only pure, non-mineral water is allowed; juices, compotes, drinks and alcohol are excluded.

Immediately before the analysis, it is recommended to avoid physical, emotional and mental stress (fast walking, excitement), as well as smoking, for 30 minutes.
If you are currently or have recently completed a course of treatment with anticoagulant drugs, you must inform the specialist of the name, dosage and duration of use.
If during blood sampling you experience nausea, dizziness, or deterioration in health, you must immediately inform medical personnel.

How is the analysis carried out?

Venous blood is collected from the ulnar vein without applying a tourniquet. To comply with the rules of coagulation, two test tubes are filled; the biomaterial from the second container containing the coagulant is subject to examination.

Where do you donate blood for a hemocoualogram?

A blood test for a hemostasiogram is carried out in public and private clinics and laboratories; this analysis is one of the basic ones. All certified laboratories with the necessary set of reagents and equipment can conduct analysis for hemostasis indicators.
The cost of tests depends on the laboratory and the set of blood factors assessed.

How many days does a coagulogram take?

The blood test itself takes from 24 to 48 hours, which is due to the need to evaluate various indicators when interacting with reagents at certain intervals. If laboratory technicians are very busy and there is a need to transport biomaterial, the study time may increase.

In what cases is a blood test for coagulogram prescribed?

Regardless of the presence of any symptoms and signs of blood coagulation pathologies, a hemostasis test is prescribed in preparation for surgery and during the gestational period. In this way, the likelihood of life-threatening risks of bleeding and thrombosis during surgery or delivery is assessed ( in a natural way or caesarean section).
Other indications for this analysis include:

• gestosis of pregnancy, as well as repeated miscarriages;
• injuries accompanied by internal and/or external bleeding;
• the presence of a tendency to thrombosis, varicose veins blood vessels, tendency to thromboembolism;
• heart attack, history of stroke, pre-infarction conditions, ischemia, arrhythmia;
• pathologies of the circulatory system;
• liver dysfunction;
• monitoring the condition during anticoagulant therapy;
• hemorrhagic pathologies, chronic anemia, frequent nosebleeds, heavy menstruation, inclusions of blood in discharge (urine, feces), sudden loss of vision, etc.;
• long-term therapy with anabolic drugs, glucocorticosteroids, oral contraceptives;
• routine medical examination.

Components of the hemostasis system

The hemostasis system includes biological substances and biochemical mechanisms that maintain blood in a liquid state, as well as prevent and stop bleeding. The main function of the hemostatic system is to maintain a balance between coagulating and anticoagulant factors. An imbalance is realized by hypercoagulation (increased blood clotting, leading to the formation of blood clots) and hypocoagulation (decreased coagulation, threatening prolonged bleeding).

Blood clotting is ensured by two mechanisms: external and internal. When tissue injuries and violations of the vascular walls occur, tissue thromboplastin (factor III) is released, which triggers the external process of blood clotting. Internal mechanism requires endothelial collagen contact vascular walls and blood components.

Indicators and norms of hemostasis

When studying indicators, different laboratories may use different techniques. Thus, the speed rate of the coagulation process varies from 5-10 to 8-12 minutes depending on the chosen technique (according to Lee-White or Mass and Margot). The assessment of compliance of results with the norm must be carried out in accordance with the standards of the specific laboratory.

Each norm of a coagulogram and its components in the table is given without taking into account gender and age indicators and individual characteristics. To decipher hemostasis indicators, you must contact a specialist.

Interpretation of hemostasis indicators

What is included in a coagulogram study? A basic hemostasis study includes several indicators assessed together.

Blood clotting time indicator

This indicator assesses the rate of formation of a fibrin clot at the site of injury and is assessed by the time interval between the onset of bleeding and its cessation. For venous blood, the reference rate of thrombus formation is 5 to 10 minutes.

Exceeding the indicator often indicates the presence of diseases and conditions such as thrombocytopenia, hemophilia, vitamin C deficiency, liver pathologies, and also occurs during therapy with indirect anticoagulants (Trental, Warfarin, Aspirin, etc.). A reading below normal indicates an accelerated ability to form clots, and may also decrease after extensive bleeding. In women, a decrease in clotting time is observed while taking it.

PTI indicator

The prothrombin index shows the ratio of the blood clotting time of the test and the accepted standard. The most favorable indicator is considered to be 97-100%, corresponding general norm. However, deviations do not clearly indicate a deviation in the functioning of the body: in women during gestation, during pregnancy, PTI can reach 150%, which is physiological feature gestational period. On average, exceeding normal limits indicates the likelihood of thrombosis, while a decrease indicates the risk of bleeding.

Thrombin time indicator

Thrombin time is the period required for the conversion of fibrin from fibrinogen. A thrombin time higher than normal indicates a reduced amount of fibrinogen in the blood, and also accompanies severe pathologies and liver diseases (cirrhosis).
A reading below normal is most often associated with increased amount fibrinogen.

APTT as a factor in monitoring anticoagulant intake

APTT is measured based on the duration of clot formation when the biomaterial reacts with calcium. This indicator is especially relevant for monitoring and correction of therapy with direct coagulants (Heparin). May also indicate disseminated intravascular coagulation syndrome, the presence autoimmune diseases, liver pathologies.

AVR

The AVR indicator allows you to assess the likelihood of such pathologies as thrombophilia, thrombocytopenia, and also changes during anticoagulant therapy, with significant internal injuries, burns.

A pronounced discrepancy with the norm is especially dangerous when the indicator is extremely low and indicates the development of a life-threatening condition - extensive and prolonged bleeding.

VLOOKUP

The CDF indicator is assessed in correlation with activated time recalcification. Low values ​​indicate increased activity hemostasis.

Estimation of fibrinogen amount

The fibrinogen protein belongs to blood clotting factors I. It is produced in the liver and a change in its quantity may indicate pathology of this body. Exceeding the norm of this indicator can accompany inflammatory diseases and tissue injuries; the deficiency is assessed as primary (genetic etiology) or secondary, provoked by excessive consumption during the process of hemostasis.

Thrombotest

Thrombotest is a method for visually assessing the amount of fibrinogen in a biomaterial. Normally, this indicator corresponds to level 4-5.

RFMK

Assessment of the concentration of soluble febrin-monomer complexes is important in the diagnosis of DIC syndrome. Interpretation of indicators is also important in case of thrombus formation, complicated pregnancy, renal dysfunction, during the recovery period after invasive procedures, etc.

Antithrombin III

A glycoprotein related to natural anticoagulants. Its norms vary significantly depending on the age of the patient. The level of antithrombin 3 in women also changes during pregnancy, which is not a pathological condition.
Causes of excess and deficiency of antithrombin III

D-dimer as an indicator of hemostasis

D-dimer is a fibrin breakdown product; the fibrinolytic activity of plasma is assessed by its amount. An increase indicates the presence of intravascular thrombosis, liver disease, ischemia or myocardial infarction, and can also develop with prolonged smoking.
The deficiency of the indicator has no clinical significance.

Estimation of bleeding time

When studying this indicator, the period from the onset of bleeding to the formation of a clot in the capillary is studied. Methodology: with a sharp sterile needle, a superficial injury is made on the earlobe and the time from the onset to the cessation of bleeding is assessed. An indicator that exceeds the norm has diagnostic value.

Features of hemostasis in pregnant women: research and interpretation of results

Changes that occur during the gestational period affect all body systems, including the process of hematopoiesis. During pregnancy, hemostasis norms change, and assessment should be based on compliance of gestational age with reference values.
The main factor in changes in blood clotting is associated with increased risks of bleeding during termination of pregnancy, placental abruption and during childbirth, and therefore fibrinolysis is suppressed.

Hemostasis of the gestational period

Normal indicators change with increasing gestational age.

	Normal 1st trimester	Normal 2 trimesters	Normal 3 trimesters
Fibrinogen	2,9-3,1	3,0-3,5	4,4-5,1
APTT	36-41	33,6-37,4	37-40
AVR	60-72	56,7-67,8	48,2-55,3
PI	85,4-90,1	91,2-100,4	105,8-110,6
RFMK	78-130	85-135	90-140
Antithrombin III	0,222	0,176	0,155
Platelets	301-317	273-298	242-263

A coagulogram is a blood test to measure its coagulability. It is important for doctors to know this result when preparing a patient for surgery. It is necessary to have data on blood clotting if a person has a disorder, if there is a history of diseases of the liver, cardiovascular and autoimmune system, varicose veins lower limbs. Using a coagulogram, the causes of bleeding are determined and the condition of a woman’s blood is monitored during pregnancy.

How to take a blood test for a coagulogram correctly - tips for taking the test

The blood clotting system is called hemostasis and protects the human body from excessive blood loss.

An analysis that tests the operation of this system is called hemostasiogram or coagulogram.

The endocrine and nervous functions body. So that the blood successfully copes with its basic functions, it should be quite liquid. Thanks to blood circulation through the vessels, tissues are nourished, useful substances are transported to all organs, the immune system is in action, and the body is provided with normal thermoregulation.

Decreased blood clotting leads to to heavy blood loss in case of bleeding of various origins.

Hypercoagulation, on the contrary, to the formation of clots, that is, blood clots.

Since a coagulogram test is vitally important, the doctor always wants to get accurate test data.

To properly donate blood for a coagulogram, you should properly prepare for the analysis. Exists row training rules, compliance with which guarantees the accuracy of the results:

• Do not eat food for 8-12 hours before taking the analysis.
• Recommended the day before in the evening, eat only a light dinner.
• You can drink before the test but only ordinary drinking water.
• Do not drink coffee or tea, juices or alcoholic beverages before the test..
• Also recommended refrain from smoking for an hour before donating blood.
• Immediately before blood collection you should take a coagulogram drink a glass of clean water.
• 15 minutes before donating blood, it is not recommended to overexert yourself emotionally or physically.
• Before taking blood, you need to be calm, balanced and relaxed, not tense.
• A patient taking medications that affect clotting should notify physicians about this.

Patients who experience symptoms of dizziness or fainting during blood sampling must warn the specialist who takes the test about this!

All blood coagulogram indicators - what each indicator means, explanation

Standard blood test for coagulogram includes many indicators. Professional interpretation of the received data is carried out by qualified specialists, analyzing all parameters together.

Blood coagulation data are especially useful if the patient:

1. There is a tendency to form blood clots.
2. Postoperative, uterine or other bleeding has begun.
3. Treatment with anticoagulants is carried out.
4. History of stroke or heart attack.
5. There are vascular diseases.
6. Liver diseases are present.

The main indicators of the coagulogram are as follows:

• Clotting time means the time interval between the time blood begins to flow from a wound, for example, when a finger is cut, and the moment when the blood stops because a fibrin clot forms in it. This interval normally for capillary blood ranges from 30 seconds to 3-5 minutes. Deoxygenated blood It takes longer to curl – within 5-10 minutes. This indicator indicates how platelets cope with their work.

The duration of bleeding from the wound may be longer, if the platelet count is low for any reason, if there is a lack of vitamin C or if the person has been taking anticoagulant medications for a long time, such as aspirin, or if hemophilia or liver disease. Blood clots faster after undergoing heavy bleeding and when using hormonal contraception.

• Prothrombin index (PTI) measured as the ratio of the clotting time of the blood plasma of a healthy person, the so-called control blood, to the clotting time of the blood of the patient from whom the analysis is taken. The PTI value shows the condition of the human liver. During pregnancy, this indicator increases - this is normal. A pathological upward shift in the prothrombin index value occurs when using oral contraceptive drugs and also if there is a risk of blood clots. When PTI decreases, there is a danger of bleeding.

When analyzing a blood coagulogram, the norm of the prothrombin index ranges from 93-107%. To maintain the normal state of this indicator, the body needs vitamin K.

• Thrombin time normally equal to 15-18 seconds, measures the interval of conversion of fibrinogen to fibrin. If the thrombin time is less than normal, most likely there is excess fibrinogen in the blood. Prolongation of the thrombin gap is associated with a hereditary deficiency of this protein or with severe liver failure.

When using heparin in the treatment of a patient, this indicator must be strictly monitored!

• Activated partial thromboplastin time (aPTT) - the most sensitive indicator of blood clotting, indicating the time of formation of a blood clot after combining calcium chloride with plasma and a number of other components. Normally, the APT coagulogram shows an interval of 30-40 seconds. The indicator is sensitive to changes in any other component of the coagulogram within 30 or 40 percent. An increase in aPTT is observed with vitamin K deficiency and liver diseases.
• Activated recalcification time (ATR) helps to understand how one of the stages of blood clotting occurs. Normally, the indicator ranges from 50 to 70 seconds. If in the analysis the coagulogram avr is shorter than the normative one, then we can talk about a state of thrombophilia. When the time interval is extended, there is a danger of heavy blood loss in case of bleeding. An increase in recalcification time occurs due to a decrease in the number of platelets in the blood, during heparin therapy, in critical conditions such as burns, trauma, shock.
• Fibrinogen concentration Normally ranges from 5.9 to 11.7 µmol/l. The rate decreases in diseases affecting the liver. Increases - with malignant neoplasms, with a lack of hormones thyroid gland, acute infectious diseases.

• Soluble fibrin-monomer complexes (SFMC) show changes in fibrin molecules under the influence of plasmin and thrombin. The upper limit of normal for RFMC per 100 ml is 4 mg. When studying the coagulogram rfmk, the decoding of the indicator serves as a marker of intravascular coagulation. Changing it depends on the same reasons as varying fibrinogen.
• Thrombotest allows you to visually see the amount of fibrinogen contained in the blood. The norm is thrombotest grade 4 or 5.
• Plasma tolerance to heparin shows the amount of thrombin in the blood. The analysis determines the time it takes for a fibrin clot to form in the blood plasma after heparin is administered to it. IN normal blood For a healthy person, this happens in 7-15 minutes. A decrease in blood resistance to the action of heparin is indicated by a tolerance interval of more than a quarter of an hour. Heparin resistance decreases in liver diseases. The tolerance time will be less than seven minutes for hypercoagulation, characteristic of pregnancy, cancer, postoperative periods, and diseases of the cardiovascular system.
• Fibrinolytic activity characterizes the ability of blood to independently dissolve blood clots. Fibrinolysin, which is capable of breaking down the structure of a blood clot, is responsible for this indicator in plasma. If blood clots dissolve faster than normal, it means the person has increased bleeding.

• Duke bleeding time characterizes the bleeding time when pricking a finger with a special lancet. The injection is made to a certain depth - 4 mm. Then, every 15-30 seconds, using special paper, one drop of escaping blood is removed from the wound. In this case, the paper does not touch the finger. After removing one drop of blood, the time is noted when the next one comes out of the wound. In this way, the time to stop capillary bleeding is checked. Normally it is approximately 1.5 to 2 minutes. The result of this test is influenced by serotonin and blood platelets.
• Fibrinogen is a protein synthesized by the liver. Under certain factors, it is converted in the hematopoietic system into the high molecular weight protein fibrin. Fibrin fibers serve as the basis for the formation of blood clots. The fibrinogen content in healthy blood should be within 2-4 g/l.

A coagulogram shows a dangerous decrease in fibrinogen levels when:

1. Toxicosis during pregnancy.
2. Malfunctions in hemostasis.
3. Cirrhosis of the liver.
4. Severe form of hepatitis.
5. Lack of B vitamins and ascorbic acid.
6. Taking fish oil.
7. Use of anabolic steroids and anticoagulants.

Fibrinogen content in the blood increases for pneumonia, acute infections and various inflammatory processes, after childbirth, during pregnancy, after surgery, for burn injuries, hypothyroidism, heart attack or stroke, as a consequence of taking hormonal drugs.

• Fibrinogen B – in a healthy blood test, this marker should be negative.
• Blood clot retraction - its normal percentage level ranges from 44 to 65. This is an indicator of a decrease in the volume of a blood clot, its contraction with the release of blood serum. Increased retraction is characteristic of anemia. The decrease occurs due to an increase in the number of red blood cells and a decrease in platelets.
• Plasma recalcification time (PRT) normally ranges from 60 to 120 seconds. This is one of the important indicators of hemostasis, which has something in common with AVR and records the clotting time of oxalate and citrate plasma, which is detected from the moment calcium salts are introduced into it. A reduction in recalcification time indicates hyperactivity of the coagulation system.

Blood coagulogram - table of normal indicators for adults and children

Main indicators of coagulogram - table of standards:

Children's indicators somewhat different. In particular, for newborns the fibrinogen norm is 1.25–3.00 g/l.

A blood coagulogram test is done for the child before any surgical intervention, if you suspect hemophilia or other anomaly of the hematopoietic system, with frequent nosebleeds.

Every qualified doctor knows that it is best to begin the treatment of any patient by collecting an anamnesis, which is nothing more than a collection of information about the state of a person’s health.

As a rule, any medical examination begins with asking the patient himself about previous diseases or surgical interventions, allergic reactions or hereditary predisposition to certain ailments and so on.

Then the doctor prescribes a series of laboratory tests or simply tests that will help supplement the anamnesis with information about the development of the disease, as well as information necessary for choosing a treatment method or further diagnosis.

(abbreviated coagulogram ) occupy an important place among laboratory blood tests, which are necessarily carried out in preparation for surgical intervention, for example, during planned or during pregnancy .

Coagulogram - what is it?

Many patients needlessly begin to worry when they hear from their attending physician such unusual at first glance words as coagulogram or else hemostasiogram . So what kind of coagulogram analysis is this and why is it taken?

First of all, it is worth noting that this is a fairly common method of studying work in modern medicine. hemostasis systems human body, which is responsible for such important vital functions as: stopping bleeding when damaged blood clots or vessels , as well as maintaining the normal fluid state of the blood.

Hence the answer to the question of what it is hemostasiogram – a study that determines how well the body’s hemostasis system functions. A blood test for a coagulogram helps to study such important function blood, as the ability to clot, i.e. formation of a blood clot.

Having received the results coagulology , the attending physician can predict in advance the outcome of surgery or childbirth. Information about blood clotting is vital in emergency situations, for example, when a person is injured, when seconds are counting and you need to stop it as quickly as possible.

Therefore, you hardly need to worry too much about how much this research costs. After all, the price of a hemostasiogram cannot be compared with the confidence that the patient will be alive and healthy.

Indications for prescribing such an analysis as a hemostasiogram are the presence of the following diseases in the patient:

• vascular thrombosis And lower extremities;
• cirrhosis chronic form;
• gestosis;
• inflammatory processes in the acute stage;
• hemorrhagic pathologies, for example, thrombocytopenia, hemophilia or von Willebrand disease.

In addition, such an analysis is necessarily prescribed to determine the rate of blood clotting in preparation for planned operations, for example, caesarean section, as well as during pregnancy to assess the state of hemostasis and before independent childbirth . Every woman in labor must have a blood test such as a coagulogram in her exchange card.

Human hemostasis system

Having determined what a hemostasis test is, it is worth understanding in more detail such a concept as blood clotting . Perhaps we should start with a definition. So, the hemostasis system of the human body is the most important biological system, the main functions of which can be considered to be the preservation of basic blood parameters, as well as stopping bleeding.

It is not for nothing that the human body is called the whole universe and is compared with complex mechanism. And the hemostasis system can serve just a shining example of how brilliantly people are made. Blood is a unique biological fluid that can literally work miracles in our body.

It not only circulates through the vessels, but also restores veins And arteries throughout his life thanks to his ability to form blood clots or dense clots, i.e. roll.

There are three main components of the human hemostasis system:

• Vascular cells endothelium (inner layer consisting of flat cells lining lymphatic and blood vessels, as well as the cavities of the heart), which, when vascular walls rupture or other damage, are capable of releasing such biologically active components as prostacyclin, thrombomodulin And Nitric oxide . They, in turn, trigger the process of blood clot formation.
• Platelets or blood platelets that have the ability to “stick together” with each other in order to subsequently form the primary hemostatic plug .
• Plasma factors (15 plasma factors in total, most are enzymes ), forming due to chemical reactions fibrin clot , which should finally stop the bleeding.

Summarizing all of the above, we can clearly answer the question of what a blood test for hemostasis shows during pregnancy, in preparation for elective surgery or during diagnostics. This test gives an idea of ​​how well or poorly a patient's blood is clotting. In other words, how quickly doctors can stop bleeding when it occurs.

Interpretation of blood coagulogram

The blood test for a coagulogram includes many different indicators that you need to be able to read correctly, i.e. understand and analyze, in other words, decipher. Unfortunately, not every doctor has the skills to decipher hemostasiogram indicators. And only a highly qualified specialist can correctly interpret certain parameters of this analysis.

After conducting laboratory tests of the patient’s blood and receiving the results, the attending physician compares the decoding of the coagulogram with the norm established for adult patients, as well as children. It is important to remember that the normal coagulogram for a child, man or pregnant woman is very different. This is due, first of all, to the peculiarities of the functioning of the body of people of different sexes in different age categories.

Coagulogram indicators

Let's consider the parameters of the blood clotting test, namely the normal hemostasiogram values. Then we will dwell on each of them in more detail, and also talk about an extended or expanded coagulogram.

It is worth noting that the table below shows several options for normal indicators of such hemostasiogram parameters as bleeding time And blood clotting time . This is due to different interpretations of the norm for these parameters by specialists involved in their study.

Indicator name (abbreviated name)	Standard value of the indicator
Blood clotting time: norm according to Mass and Margot; Lee-White norm.	from 8 to 12 minutes; from 5 to 10 minutes.
Bleeding time: norm according to Shitikova; Duke norm; Ivy norm.	no more than 4 minutes; from 2 to 4 minutes; no more than 8 minutes.
International Normalized Ratio (INR or INR)	0,82-1,18
Thrombin time (TV)	14-21 seconds
Prothrombin index (PTI)	73-122 %
Activated Recalcification Time (ATR)	81-127 seconds
D-dimer	250.10-500.55 ng/ml*
Prothrombin time (PT) according to Quincke	11-15 seconds
Antithrombin III (AT III)	75,8-125,6 %
Activated Partial Thromboplastin Time (APTT)	22.5-35.5 seconds
Fibrinogen	2.7-4.013 grams
Soluble fibrin-monomer complexes (SFMC)	0.355-0.479 units*

*International unit (IU) or Unit of action (AU) , i.e. a measure of measuring the dose of a substance based on its biological activity.

*Nanogram per milliliter Source: Wikipedia

Clotting time

This laboratory test of the patient's blood gives the doctor an idea of ​​the time it takes for the body to form a blood clot. There is no shorthand symbol for this parameter in the analysis. During the research, biological material (blood) taken from a patient’s vein is placed in a sterile and dry tube, and then the time is noted and they wait until a visible blood clot forms.

When the blood clotting time is normal, the doctor can conclude that the hemostasis system is working correctly, and also exclude some pathological conditions, for example, hemophilia or DIC syndrome , in which a blood clot does not form at all. If the blood clotting time deviates from the norm (increase or decrease in indicators), you should understand the reasons in more detail.

For example, prolongation of bleeding time may occur with hemophilia, systemic lupus erythematosus or when rheumatoid arthritis , and also when peritonitis , for chronic liver pathologies , at pneumonia and the presence of a malignant tumor. A shortened bleeding time may be a signal of development or hemorrhagic shock , and myxedema.

In addition, all coagulogram indicators, including this one, may deviate from the norm during pregnancy. Women, as a rule, first learn about the name of a blood clotting test during pregnancy, when they are required to undergo many laboratory tests in order to monitor and promptly influence the health of the mother and unborn child.

The changes that rapidly occur in the body of a pregnant woman do not leave their mark on the properties and characteristics of the blood. It is noteworthy that there is a gradual decrease in blood clotting time starting from the first trimester, and in the third trimester this indicator can differ greatly from the norm. However, do not be afraid, since this is just one of the protective mechanisms that help prepare the female body for childbirth and reduce possible blood loss.

Bleeding time

In accordance with the standards, the duration of bleeding should not be less than or more than a few minutes from the moment of puncture, the so-called primary hemostasis. To complete the process, i.e. The formation of a blood clot should take an average of 10 minutes maximum. Blood clotting time is a very important indicator that plays a big role in preparing the patient for surgery, for example, during a cesarean section.

The norm of blood clotting in women does not differ from the standards established for adults. The rate of blood clotting in children depends on the age of the child. On average, the duration of bleeding should not exceed 2-4 minutes, and a blood clot should form within 2-5 minutes.

Bleeding time may be increased if:

• hemophilia;
• thrombocytopenia , i.e. with a lack of platelets in the blood;
• hemorrhagic fever , for example, when Ebola or Crimea-Congo;
• liver damage alcohol (intoxication);
• thrombocytopathy;
• drug overdose.

How to take a blood clotting test?

In order for the doctor to receive undistorted information after laboratory tests, one should take the correct approach to taking any tests, including blood clotting tests. Biological material is taken in the morning, always on an empty stomach. It should be remembered that at least 8, and preferably 12, hours must have passed since the last meal.

In addition, you should refrain from taking alcoholic beverages and medications on the eve of the study, as this may affect the test result. If the patient is forced to take any medications, he must remember to inform the medical professional about this.

Prothrombin time

What is prothrombin time? This is one of the main laboratory indicators of a coagulogram used by doctors to assess the hemostatic system of the human body as a whole, as well as to determine the effectiveness of drugs that prevent blood clotting.

PT reflects phases 1 and 2 of plasma coagulation. In other words, the time of formation of a thrombin clot in the blood when thromboplastin and calcium are added. For this parameter, the abbreviated designation PV is accepted; sometimes PVT is also used. Blood clotting test parameters such as: international normalized ratio (INR) And prothrombin index (PTI) are derived from prothrombin time, the norm of which varies depending on the age and gender of the patient.

For example, the normal thrombin time in women and men is 11-15 seconds. Standards are established for children depending on their age. For example, for newborns - 13-17 seconds or 14-19 seconds for premature babies. For an older child (from 10 years old) the norm is 12-16 seconds, and for a younger child – 13-16 seconds.

Thrombin time is higher than normal - what does this mean? Deviation from the standard indicators established for a given coagulogram parameter may mean the following:

• flaw vitamin K in organism;
• low concentration or lack of clotting factors 1,2,5,7, and also 10;
• disruption of the normal functioning of the liver, liver failure or other diseases of this organ;
• Availability DIC syndrome .

Prothrombin time is increased, what does this mean? As a rule, exceeding the PT indicator is associated with the patient taking medical supplies, belonging to the group of anticoagulants, i.e. drugs with anticoagulant properties, for example , Kumadinilin or .

International Normalized Ratio

Prothrombin ratio (abbreviated PTI) or INR in a blood test, what is it? Let's start with a little background. Such a parameter as INR in the hemostasiogram appeared in 1983, when World organization of Health (hereinafter referred to as WHO) decided to streamline the work of research laboratories and bring all blood clotting test indicators to a single standard that is understandable to doctors all over the world.

Previously, each laboratory could use different thromboplastin reagents , which could distort the final research results. This coagulogram parameter is abbreviated as INR or INR. In domestic medicine, you can currently still find instead of INR such an indicator as the prothrombin index, which reflects how well the patient’s blood clots.

However, due to different methods for determining this parameter, it is considered unstable and therefore it is customary to use INR abroad. In a blood test for PTI and INR, the norm is set at the level:

• PTI - 70-100, and for patients taking Warfarin – 24,0-42,6;
• INR – 0.82-1.18.

So what is INR in a blood test? This is an indicator that is nothing more than the ratio of the PT of the patient’s analysis and the PT of the control sample. The INR norm in a human blood test according to international standards can range from 0.82 to 1.18.

If there is a deviation from the above values, the patient may be diagnosed with the following diseases:

• with elevated PT and INR levels: chronic , deficit vitamin K, , amyloidosis, DIC syndrome, reduced level fibrinogen, nephrotic syndrome, clotting factor deficiency (2.5, 7 and 10);
• at reduced rates PT and INR: vascular thromboembolism , increased activity of factor 7, thrombosis or activation fibrinolysis.

In addition, an increase in INR and PT may indicate the presence of anticoagulant drugs in the patient’s blood. Therefore, the INR norm when taking Warfarin differs from established standards. For patients taking this drug and drugs similar in action to it, use the following range of normal INR values ​​- 2.0-3.0.

The INR norm in the blood of women usually does not differ from general values. But during pregnancy, the female body changes so much that the INR norm during pregnancy may not coincide with the above numbers.

Activated partial thrombin time

Blood test for APTT - what it is? This is another analysis indicator that provides information about the effectiveness of plasma factors designed to quickly stop bleeding. This parameter is abbreviated as APTT.

APTT blood test - What is this? The parameter is often called activated partial thromboplastin time. APTT, like APTT, provides information about the rate of formation of a fibrin clot and best characterizes the internal process of hemostasis. It is believed that the APTT indicator is the most accurate, but at the same time the most sensitive, because may vary depending on the reagents used in laboratory tests.

The general norm of aPTT in human blood is set at 22.5-35.5 seconds. The APTT rate in women also corresponds to the above values. However, as is the case with other coagulogram parameters, the APTT rate during pregnancy does not always correspond to the general rules. Let us consider the reasons for the deviation of this indicator from the norm.

When the above reasons are excluded, and the aPTT is higher than normal, this means that the patient may have diseases such as:

• fibrinolysis;
• acquired or possibly congenital clotting factor deficiency (8, 9, 11, 10, 12, 2 and 5);
• DIC syndrome (2 or 3 stages);
• autoimmune pathologies(more often systemic lupus erythematosus );
• liver diseases.

When APTT is low, what does it mean? If the value is below normal, this indicates that the blood's ability to clot is reduced. The main reasons for this condition may be:

• DIC syndrome 1st degree;
• increased coagulability;
• an error during laboratory testing, for example, incorrect blood sampling.

Soluble fibrin-monomer complexes

Abbreviated in a coagulogram as RFMK. RFMK analysis, what is it? Let's start with a definition fibrin-monomer complexes - these are products of the breakdown of a blood clot in the process fibrinolysis . According to researchers, this indicator is quite difficult to reliably determine, since soluble fibrin-monomer complexes are very quickly removed from the blood.

Such a parameter as RFMC plays an important role in diagnosis DIC syndrome (full name: disseminated intravascular coagulation syndrome). The norm of RFMK in human blood is 0.355-0.479 units. However, during pregnancy, RFMC norms may differ significantly from the above indicated level. Since the female body is actively preparing for the upcoming birth, the basic parameters of the blood change along with it, including its ability to clot.

This is a kind of defense mechanism that helps minimize the risk of bleeding. Counts normal deviations RFMK level during pregnancy is up to 5.1 ml. per 100 ml. blood. If RFMK is elevated, what do these analysis results mean?

When RFMK is increased in a patient’s coagulogram, the reasons may be as follows:

• thromboembolism deep veins of the extremities or pulmonary artery;
• sepsis;
• or preeclampsia during pregnancy;
• connective tissue pathologies;
• renal failure in the chronic or acute stage.

An increase in this indicator is often found in patients who have recently undergone surgery. Therefore, in postoperative period analysis for RFMK may deviate from the norm.

Activated recalcification time

Abbreviated as ABP in the analysis, it denotes the time required for the formation of fibrin in blood plasma saturated with platelets and calcium. This parameter is also used to evaluate the blood coagulation system as a whole. AVR reflects the interaction of cellular and plasma components of hemostasis.

It is noteworthy that the value of this parameter may vary depending on the reagents used in laboratory studies. As a rule, a shortened recalcification time indicates the patient’s body’s tendency to form blood clots, and an extended one indicates hemophilia, as well as a decrease in the number of platelets and a change in their basic characteristics.

Prothrombin index. Norm for women

The abbreviated name for this parameter in the analysis is PTI. Blood test for PTI - what is it? Prothrombin index – this is the ratio of the established ideal prothrombin time value to the prothrombin time indicator in the patient’s analysis multiplied by 100%.

It is noteworthy that this indicator is currently almost never used, since WHO recommends using this more resistant laboratory research parameter as INR. The normal level of PTI in the blood for a healthy person is set at 73-122%.

As a general rule, the rate of IPT in women should not differ from the above values, with the exception of the period of pregnancy, when blood clotting increases. Therefore, if a woman’s coagulogram deviates from the norm, she should consult a doctor for advice. This parameter increases, as a rule, if the human body lacks vitamin K, and there is also a deficiency of blood clotting factors.

In addition, an increase in PTI is due to treatment with anticoagulants such as , Warfarin or Neodicoumarin , as well as when receiving Heparin and its analogues. PTI decreases with liver damage, for example, with cirrhosis and hepatitis, with vascular thrombosis and during pregnancy.

Norm of prothrombin for women in the blood

In the hemostasis system, 15 coagulation factors play a fundamental role, i.e. substances that characterize the correctness of its operation. One of the most important factors is considered prothrombin or factor II, also known as thrombogen . This is a protein that is a precursor to thrombin, which in turn is responsible for the coagulation function of the blood - it stimulates the formation of a thrombus (blood clot).

The level of prothrombin in the blood is determined using the following tests:

• PV according to Kwik – the norm for women is 78-142%;
• INR or INR – the norm for women is 0.85-1.15.

If the level of factor II is higher than normal, then blood circulation is hampered due to the fact that the blood becomes viscous, as a result, the blood vessels become clogged. In this condition, the patient’s body is more at risk than ever before. strokes and heart attacks , and also significantly increases the risk of developing malignant tumors or thromboembolism .

In case the level thrombogen is reduced, the formation of a blood clot occurs abnormally slowly, which is fraught with significant blood loss if bleeding develops. As a rule, the causes of such a failure in the hemostatic system are: lack of vitamin K in the body or other congenital and acquired factors.

Thrombin time

Abbreviated name – TV. This parameter characterizes the final stage of hemostasis and determines the length of time required for clot formation fibrin when added to blood plasma thrombin . TV control is always carried out in combination with PT and APTT for the most effective diagnostics fibrinogen pathologies innate nature, as well as to assess the effectiveness of fibrinolytic and heparin therapy.

Fibrinogen

What is a fibrinogen blood test? First blood clotting factor or fibrinogen - this is nothing more than a protein formed under the influence Hageman factor in the liver, and subsequently under its influence transforms into insoluble fibrin . The presence of fibrinogen is determined by performing a thrombotest.

Thrombotest grades 4 and 5 are considered normal. It is worth noting that since fibrinogen (an acute phase protein), its level increases in the blood during stress, injury or infection. As a general rule, the level of fibrinogen in the blood should be between 2.7 and 4.013 grams. The level of fibrinogen in women's blood should not be lower or higher than the specified values, except during pregnancy.

A pregnant woman's blood parameters undergo changes, as does her entire body. Many are launched protective systems, including the hemostatic system, is preparing for the upcoming delivery. Often, already in the first trimester, fibrinogen levels may be slightly higher or lower than normal. For this period of pregnancy, indicators are set from 2.3 to 5 g/l.

When the level of this protein increases, the blood becomes denser and thicker. Because of this, the process of thrombus formation begins, which harms the child, because he will suffer from an acute lack of oxygen and, as a consequence, from a deficiency of important micro- and macroelements, as well as vitamins. During pregnancy in the second trimester, the fibrinogen level should be within the normal range of 2.4-5.1 g/l, and in the third trimester - up to 6.2 g/l.

Elevated levels of fibrinogen are also observed with:

• burn disease;
• menses;
• rheumatoid;
• amyloidosis;
• pneumonia;
• pyelonephritis;
• systemic scleroderma;
• peritonitis.

In addition, protein levels are affected by drugs such as Heparin and lane oral contraceptives.

A low level of fibrinogen indicates that the patient has diseases such as:

• DIC syndrome;
• prostate cancer;
• cirrhosis of the liver and other organ pathologies;

Fibrinogen levels may decrease during poisoning Heparin , as well as when the patient receives anabolic steroids, androgens, And barbiturates .

Antithrombin III

This physiological anticoagulant in its structure belongs to glycoproteins , i.e. substances capable of inhibiting coagulation factors 9, 10 and 12 and thrombin. It is synthesized in liver cells. Standard indicators This coagulogram parameter varies depending on the patient’s age.

For adults, the normal rate will be 75-125%, for newborn children - 40-80%, for children from 10 to 16 years old - 80-120%, and under 10 years old - 60-100%. If antithrombin 3 is low, what does this mean? A decrease in the level of this anticoagulant may be associated with the presence of such diseases in the patient as DIC syndrome, sepsis, ischemia, liver cirrhosis, thromboembolism or thrombosis.

In addition, antithrombin III may decrease in the last trimester of pregnancy and when the patient takes Heparin or fibrin inhibitors. When antithrombin 3 is elevated, inflammatory pathologies may be the cause, e.g. peritonitis, pyelonephritis And pneumonia, as well as hepatitis and deficiency vitamin K.

D-dimer

Another indicator of an extended coagulogram, with the help of which the doctor analyzes not only blood clotting, but also the anticoagulant system of the human body. D-dimer - these are split fibrin strands. Only an increased result of this parameter is significant, which indicates the development of liver diseases in the patient’s body, DIC syndrome, thrombosis, ischemia, arthritis, myocardial infarction.

In addition, an increase in D-dimer is a sign of heavy smokers.

What is a coagulogram during pregnancy? This is the same coagulogram that is necessarily prescribed to women during pregnancy, as well as immediately before preparing for childbirth.

During pregnancy, the norm for all blood clotting test indicators does not correspond to generally accepted values ​​for the body of a healthy adult.

This is due, first of all, to the fact that the hemostasis system of a pregnant woman undergoes serious changes, as does her entire body as a whole due to the appearance of another circle of blood circulation - uteroplacental. An important role is also played by the hormonal background, which is dominated by .

It is noteworthy that during pregnancy the activity of blood clotting factors such as 7,8 and 10, as well as fibrinogen, increases significantly. This is a kind of natural protective mechanism designed to help increase the chances of a favorable birth outcome.

Fibrin fragments are deposited on the walls of blood vessels and thus the fibrinolysis system is suppressed. This allows the female body to be safe in case of placental abruption or miscarriage, with uterine bleeding and during the formation of intravascular thrombi.

Decoding coagulogram indicators during pregnancy

We talked about what a coagulogram is and why this test is taken. Now let’s figure out how to properly undergo a hemostasiogram so that, based on the results obtained, the doctor can make the right conclusion and choose an effective treatment plan.

So, if you need to do a blood clotting test, then remember the following rules:

A standard hemostasiogram can be done in most public clinics, and an expanded or detailed analysis is more often available in paid medical institutions. For example, in the Invitro laboratory, a coagulogram can be done quite quickly. As a rule, the test result can be collected within a couple of days. This is due to the need for a number of chemical reactions that require a certain amount of time, which simply cannot be avoided.

However, in any case, the result paid analysis you will receive it in your hands much faster than in government agency, where the laboratory is heavily loaded due to the influx of patients or may not have available certain reagents necessary for research. The cost of the analysis depends on the number of parameters that need to be studied and varies from 1000 to 3000 rubles.

Today's report discusses the coagulogram: what kind of analysis it is, the norm, interpretation. For convenience, we have placed the data in tables.

Coagulation blood testing is a comprehensive laboratory assessment of the state of hemostasis. The main function of hemostasis is to participate in the process of stopping bleeding and disposing of blood clots. The analysis allows you to diagnose malfunctions in the mechanisms of blood clotting, and is also mandatory before any surgical intervention and when determining the causes of miscarriage.

Violation of the integrity of tissues and blood vessels activates the launch of a sequence of biochemical reactions of protein factors that ensure coagulation during bleeding. The final result is the formation of a blood clot from fibrin strands. There are 2 main pathways leading to blood clotting:

• internal - for its implementation, direct contact of blood cells and the subendothelial membrane of blood vessels is required;
• external - activated by the protein antithrombin III, secreted by damaged tissues and blood vessels.

Each of the mechanisms individually is ineffective, however, forming a close relationship, they ultimately help stop bleeding. Violation of the compensatory mechanisms of the hemostatic system is one of the reasons for the development of thrombosis or bleeding, which poses a threat to human life and health. This is what emphasizes the importance timely diagnosis state of the hemostasis system.

Coagulogram - what kind of analysis is this?

Patients often wonder what a blood coagulogram is, for example, before surgery or during pregnancy, and why is it so important to take it?

Coagulogram is medical analysis by assessing the state of the system that starts and stops the blood clotting mechanism.

The obligatory examination before surgery is determined by possible risk bleeding during surgery. If failures in the hemostatic system are detected, the patient may be denied surgical intervention if the risk of bleeding is too great. In addition, the inability to carry out one of the coagulation mechanisms can be the cause of miscarriage.

The effectiveness of therapy for any pathology affecting the hemostatic system requires strict control and is implemented through the examination in question. Positive dynamics indicate the correctness of the chosen tactics and a favorable outcome. Lack of improvement requires immediate correction of the treatment regimen by a specialist.

What is included in a blood coagulogram?

Coagulogram parameters: prothrombin index (PTI), international normalized ratio (INR), fibrinogen protein, antithrombin (AT III), activated partial thromboplastin time (APTT) and protein fragment (D-dimer).

PTI and INR

Using two parameters - PTI and INR, it is possible to assess the normal functioning of the external and general pathway for blood coagulation. In the case of a decrease in the concentration of protein factors in the serum of the subject, a deviation of the considered criteria is observed to be greater than the norm.

It has been established that prothrombin is produced by liver cells (hepatocytes) and requires vitamin K for its normal functioning. In case of its hypofunction (deficiency), a failure occurs in the formation of a blood clot. This fact is the basis for the treatment of people with a predisposition to thrombosis and cardiovascular pathologies. The essence of treatment is to prescribe drugs that interfere with the normal synthesis of the vitamin. Both criteria under consideration are used to determine the degree of effectiveness of these tactics.

Formula for calculating prothrombin index:

PTI std. – the amount of time it takes for plasma to clot in the control sample after adding clotting factor III.

The INR coagulogram is calculated using the following formula:

ISI (International Sensitivity Index) is a standard coefficient.

It is known that the values ​​under consideration are characterized by an inverse correlation, that is, the higher the prothrombin time index, the lower the INR. The statement is also true for the inverse relationship.

Fibrinogen

Fibrinogen protein synthesis occurs in hepatotocytes. Under the influence of biochemical reactions and degrading enzymes, it takes an active form in the form of fibrin monomer, which is part of the blood clot. Protein deficiency can be due to two reasons: congenital genetic mutations and excessive depletion for biochemical reactions. Similar condition characterized by excessive bleeding and poor blood clotting.

In addition, if tissue integrity is compromised as a result of mechanical damage or inflammatory processes, fibrinogen production increases significantly. Measuring protein concentration allows you to diagnose pathologies of the cardiovascular system (CVS) and liver, as well as assess the risk of possible complications.

AT III

AT III is one of the most important factors, the main producers of which are hepatocytes and endothelium, which lines the internal cavity of blood vessels. The main function is to suppress coagulation processes by inhibiting the functioning of thrombin. Thanks to the normal ratio of these two proteins, stable hemostasis is achieved. Insufficient synthesis of antithrombin leads to increased coagulation processes and a critical level of thrombosis.

APTT

APTT in a coagulogram is a criterion that allows one to evaluate the normal implementation of the internal pathway. Its duration is directly dependent on the concentration of kininogen (precursor of polypeptides) and various protein coagulation factors.

The APTT value is determined by measuring the time it takes to form a full-fledged blood clot when reagents are added to the test sample. Deviation of the criterion to a greater extent than the norm leads to an increase in the frequency of bleeding, and to a lesser extent – ​​to excessive formation of blood clots. In addition, isolated use of aPTT is acceptable in order to reliably monitor the effectiveness of the use of anticoagulant drugs.

D-dimer

Normally, a blood clot should undergo destruction (destruction) over time. By measuring the D-dimer value it is possible to determine the efficiency and completeness of this process. In case of incomplete dissolution of the thrombus, an increase in the criterion is noted. In addition, the use of D-dimer to monitor the effectiveness of anticoagulant treatment is acceptable.

Norm and interpretation of blood coagulogram in adults in the table

All coagulogram indicators (which means each criterion and interpretation) are presented in the table.

Age	Normal values	Reasons for the increase	Reasons for the downgrade
PTI, %
Any	From 70 to 125	· Disseminated intravascular coagulation syndrome (DIC syndrome); · Thrombosis; · Increased functional activity of proconvertin.	· Lack of clotting factors; · Development of mutant proteins that cannot take part in biochemical processes; · Hypofunction of vitamin K; · Leukemia in the acute stage; · Pathologies of the heart muscle; Liver diseases ( chronic hepatitis, cirrhosis, cancer); · Disturbances in the functioning of the bile ducts; · Malignant tumor of the pancreas; · Taking anti-clotting medications.
Up to 3 days	1,1-1,37	Similar to PTI	Similar to PTI
Up to 1 month	1-1,4
Up to 1 year	0,9-1,25
1-6 years	0,95-1,1
6-12 years	0,85-1,25
12-16 years old	1-1,35
Over 16 years old	0,85-1,3
Fibrinogen, g/l
Any	1,75 — 3,6	Acute stage infectious process; · Violations in the body's natural defenses; · Heart pathologies; · Oncopathology; · Malignant lesion of lymphatic tissue; · Kidney diseases; Chronic viral hepatitis; · Violation of tissue integrity of unknown etiology.	· Congenital absence of fibrinogen protein; DIC syndrome; · Hereditary hemophilia; · Liver diseases; · Severe degree of malignant oncopathology; · Anemia; · Extensive infection of the body with bacteria; · Lack of macro- and microelements as a result of disruption of the digestive process; · Reaction to blood transfusion.
AT III, %
Up to 3 days	57-90	· Disturbances in the process of production and outflow of bile; · Hypofunction of vitamin K; · Menstruation period; · Taking anticoagulant drugs; · Chronic excess globulin content as a result of liver pathology.	· Hereditary defect; DIC syndrome; · Formation of blood clots in deep veins; · Liver diseases; · Heart attack; · Inflammatory damage to intestinal tissues; · Malignant tumors; · Organ sepsis.
Up to 1 month	60-85
Up to 1 year	70-135
1-6 years	100-135
6-12 years	95-135
12-16 years old	95-125
Over 16 years old	65-127
APTT, sec
Any	20,8 – 37	· Hereditary defect; · Low concentrations of vitamin K; · Genetic mutations; · DIC syndrome; Renal or liver failure; · Anemia; · Taking anticoagulant medications.	· Bleeding before biomaterial collection; · Oncological disease.
D-dimer, µg FEU/ml
Any	0 – 0,55	· Thrombosis; DIC syndrome; · Infection of the body; · Mechanical injuries; · Cancer.	—

Important: when selecting reference (normal) values, the age of the subject must be taken into account.

Peculiarities

A referral for a blood test for a coagulogram can be prescribed by a physician, surgeon, gynecologist or hepatologist. Moreover, in each specific case a certain set of criteria is selected. The determined coagulogram indicators can vary from two to a full complex, including all 6 criteria. Advanced analysis indicators are significant for a comprehensive comprehensive assessment of the functioning of the mechanisms that ensure blood clotting.

It should be noted that deciphering a blood coagulogram in adults should be carried out strictly by a specialist. Independent interpretation for the purpose of selecting treatment is unacceptable; this can lead to complications of the disease and death. In addition, the analysis in question is not enough to make a final diagnosis. It should be used in combination with additional laboratory and instrumental methods.

Deviation from the norm

It should be noted that a slight deviation from the norm of tenths or hundredths of units does not have diagnostic significance. This is explained by daily fluctuations in all laboratory readings of a person, as well as individual characteristics.

Significant deviations from reference values—by several units or more—acquire diagnostic value. A tenfold increase in the criterion indicates a severe stage of the pathology and requires immediate treatment.

Coagulogram during pregnancy

During pregnancy, a detailed coagulogram analysis is mandatory for all women. This fact is explained by the fact that a violation of the mechanisms that ensure blood clotting long time may occur without clinical signs.

The standard frequency of examination is once every trimester, however, if a woman has varicose veins veins, renal or liver failure or chronic autoimmune pathologies, then the frequency increases at the discretion of the doctor.

Normal values ​​for pregnant women

When deciphering the results, you should take into account the exact week of pregnancy, since the indicators differ for each of them.

Week of pregnancy	Reference values
PTI, %
Similar to values ​​for non-pregnant women: from 70 to 125
INR
13-20	0,55-1,15
20-30	0,49-1,14
30-35	0,55-1,2
35-42	0,15-1,15
Fibrinogen, g/l
Up to 13	2,0-4,3
13-20	3-5,4
20-30	3-5,68
30-35	3-5,5
35-42	3,1-5,8
42-	3,5-6,55
AT III, %
13-20	75-110
20-30	70-115
30-35	75-115
35-42	70-117
APTT, sec
Similar to values ​​for non-pregnant women: 20.8 – 37
D-dimer, µg FEU/ml
Up to 13	0-0,5
13-20	0,2-1,43
20-30	0,3-1,68
30-35	0,3-2,9
35-42	0,4-3,15

Who needs a coagulogram?

The main indications for conducting an extended examination for a person:

• suspicion of DIC syndrome;
• carrying out an operation;
• frequent nose bleed or bleeding gums;
• hematomas of unknown etiology;
• chronic anemia;
• heavy and prolonged menstruation;
• a sharp unexplained decrease in visual acuity;
• thrombosis;
• presence of a family history of hemostasis disorders;
• detection of lupus antibodies;
• CVD diseases with concomitant pathologies;
• intrauterine growth retardation;
• recurrent miscarriages (permanent miscarriage).

Hemostasiogram and coagulogram - what is the difference?

People are often concerned about the question: what kind of tests are a coagulogram and a hemostasiogram, and are there any differences between them?

A coagulogram is part of a hemostasiogram; it allows you to evaluate the correct implementation of the coagulation mechanisms themselves. In turn, a hemostasiogram is an advanced diagnosis that takes into account the entire cellular composition of the blood (erythrocytes, neutrophils) and indicators included in hemostasis (hematocrit, thrombocrit).

How to take a coagulogram test?

The most reliable results are achieved with accurate implementation of the analysis methodology. And just as important proper preparation to a blood coagulogram.

The most common question is whether it is necessary to take a coagulogram test on an empty stomach or not? Yes, you should take biomaterial strictly on an empty stomach. Minimum interval after last appointment food should be 12 hours. The process of digesting food is a complex multi-stage process in which everyone is involved biological fluids person. Non-compliance of this rule may lead to false results.

Preparation for the examination also means eliminating physical and emotional stress for the person at least 1 hour before collecting the material. Severe stress changes the condition of human tissues, as well as the biochemical composition of fluids. And before you go to treatment room, it is recommended to sit in the laboratory for at least 15 minutes in a free position and try to calm down as much as possible.

Taking anticoagulant medications significantly distorts the results, up to complete unreliability. Therefore, they are like any other medications(including oral contraceptives) must be excluded 3 days before. If this is not possible, inform the laboratory employee about all medications you are taking.

Smoking is prohibited 30 minutes before, and drinking alcohol is prohibited 24 hours before. At least 1 month must pass from the moment of blood transfusion, since this can significantly distort the value of fibrinogen and APTT.

What influences the result?

If even one of the following conditions of damage to the biomaterial occurs, the analysis must be canceled and the result is considered invalid:

• violation of the temperature regime for storing or taking biomaterial;
• hemolysis - destruction of red blood cells;
• the presence of fatty inclusions in the serum;
• the volume of red blood cells critically deviates from the norm;
• the presence of anticoagulant molecules in the biomaterial as a result of taking drugs.

The biomaterial should be re-sampled in compliance with all rules.

How many days does a coagulogram take?

The state clinic provides the opportunity to take an analysis with a minimum set of indicators, as a rule, this is a coagulogram of PTI and INR. The execution time does not exceed 1 day, not counting the day of collection of the biomaterial.

Private clinics offer both a limited analysis option (price starts from 200 rubles) and an extended full one (from 1,500 rubles). The duration is similar to state laboratories.

Thus, to summarize, it must be emphasized that:

• Timely detection of hemostasis disorders can significantly reduce the risk of possible bleeding or excessive clotting, threatening the formation of a blood clot;
• before submitting the biomaterial, it is important to prepare properly;
• laboratory data are not sufficient to make a final diagnosis, because deviations from the norm can be caused by a number of pathological conditions. Determining the final diagnosis involves the use of additional laboratory and instrumental diagnostic methods.