The results of the coagulogram are normal. Coagulogram - what kind of analysis it is, the correct interpretation of the results. Where can I get the analysis done?

A coagulogram is a test performed to study blood clotting. The primary examination is called basic, and if a pathology is detected, a detailed examination is carried out. The indicators revealed during the analysis make it possible to determine the state of hemostasis. Increased coagulation may indicate a risk, and decreased coagulation provokes bleeding.

A complete assessment of the coagulogram is carried out using numerous clotting factors. Without this, the analysis is considered indicative. So, what kind of analysis is this, a coagulogram, what does it include, what does it show during pregnancy, where is the blood taken for it - you will find answers to all questions in this article.

Who is it prescribed to?

A coagulogram is prescribed if there are indications listed below. It is of particular importance during pregnancy, so pregnant women undergo it most often. For ordinary people procedure required before surgical interventions and in the presence of cardiovascular pathologies.

About who is prescribed and how it is carried out coagulogram, a specialist will tell you in the following video:

Why undergo the procedure

The data obtained at the time of analysis helps to recognize all disturbances that occur in homeostasis. Some deviations are quite normal, but sometimes they indicate the development of diseases in the body. In pregnant women, a coagulogram is used to determine the risk of miscarriage, which helps to neutralize catastrophic consequences in a timely manner.

Pregnant women are required to undergo this test every trimester of their pregnancy. However, an unscheduled appointment of a hemostasiogram is also possible in cases where:

1. there is uterine hypertonicity;
2. there are signs of gestosis (swelling, protein in the urine, high blood pressure);
3. Miscarriages have previously occurred.

For ordinary people, a coagulogram is usually performed to exclude the possibility of any diseases. Patients with cardiac problems require testing more often, and the doctor prescribes it at his own discretion.

Types of coagulogram

The hemostasiogram is divided into basic (approximate) and detailed.

• In the first case, the analysis only reveals the presence of disturbances in hemostasis.
• In the second case, they carry out full research, establishing the cause of this phenomenon and distinguishing pathologies of hemostasis from diseases with a similar effect. At the same time, a quantitative and qualitative assessment of such violations is carried out.

Indications for testing

A coagulogram is required in a number of cases:

• For liver diseases.
• During the period of hirudotherapy.
• The presence of autoimmune pathologies.
• Pregnancy. The study is usually carried out every trimester, which allows you to immediately detect changes occurring in the body. The frequency of coagulation tests increases if gestosis or fetoplacental insufficiency is detected.
• Taking contraceptives. The study is done at least once every 3 months.
• Blood clotting disorders.
• Cardiological pathologies.
• Planned operations.
• Before the appointment and its components.
• Vascular disorders.

It is worth considering the procedure if a person develops bruises even after minor injuries, and bleeding often occurs that is difficult to stop. A hemostasiogram may be prescribed during selection medicine, which reduces clotting, and to control the effect of such drugs.

About indications and contraindications for the procedure A specialist will tell you about coagulograms in the continuation of the previous video:

Contraindications and safety

There are no contraindications for the procedure. The coagulogram is safe for any category of patients.

Preparation for the procedure

Preparation for a hemostasiogram is a prerequisite. Before the study, they refuse to eat, so you can take your last meal only 8 hours before the procedure (preferably 12 hours). Be sure to exclude alcohol, coffee, soda and any other similar drinks. Only clean water is allowed to be consumed.

Before starting the procedure, you should warn your doctor about the medications you are taking at this time. This is especially true for medications that affect the blood clotting process. It is important to maintain a calm, balanced state and not overexert yourself physically. It would be a good idea to drink a glass of cool water before the coagulogram.

Read below about how to donate blood for a coagulogram test.

How it's going

Blood is drawn from a vein or finger. The laboratory technician (after disinfecting the instruments and the blood collection site) should puncture the skin area in the least traumatic way to prevent distortion of the results due to the inclusion of tissue thromboplastin particles in the analysis. At the time of drawing blood, to eliminate this possibility, the laboratory assistant fills 2 test tubes with material, sending only the last one for testing. To collect blood from a vein, the use of a tourniquet is not required, and a special coagulant is placed in the test tube.

At the time of the procedure discomfort associated only with skin prick and needle penetration. After a hemostasiogram, slight weakness may be felt in the limb from which blood was taken. We will tell you below about deciphering the blood coagulogram in adults and the normal indicators.

Decoding the results

The coagulogram must be deciphered according to indicators. What do they mean?

1. APTT. It is a study of the time it takes for a blood clot to form. The norm is considered to be 30-40 seconds. If the period is longer, this may indicate liver disease, lack of vitamin K or hemophilia.
2. Lupus anticoagulant. This is an optional indicator, therefore it is examined only if there are suspicions of autoimmune pathologies. Often with them there is also an increase in APTT. Taken together, this confirms the presence of an autoimmune disease.
3. Prothrombin. This is a protein that, under the influence of vitamin K, is formed into thrombin. Deviations from normal values indicate deterioration of the liver and gastrointestinal tract.
4. Fibrinogen. The synthesis of this enzyme occurs in the liver, and normal values ​​are considered to be between 2 g/l and 4 g/l. In pregnant women top figure in the last period of pregnancy should be 6 g/l. This enzyme is sensitive, so changes in this factor towards a decrease indicate disseminated intravascular coagulation syndrome, hepatitis, toxicosis, liver cirrhosis, and lack of vitamins. Sometimes this phenomenon is also a consequence. An increase in fibrinogen can provoke tissue necrosis, hypothyroidism, inflammation, First stage development, burns, infection, taking contraceptives.
5. Thrombin time shows the period of synthesis of fibrinogen protein into fibrin. The norm is 11-18 seconds. Thrombin time may be higher during pregnancy. If deviations from the norm are detected, we can talk about an excess or deficiency of fibrinogen.
6. Prothrombin time. This is the period of conversion of the inactive form of the protein (prothrombin) to the active form (thrombin). It is thanks to this enzyme that a clot is formed that stops bleeding. At high rates liver pathologies, deficiency of coagulation factors or hypovitaminosis K are diagnosed.
7. Platelets- these are the main cells necessary to maintain hemostasis. Normal indicators- 150000-400000 µl. If there is a deficiency, thrombocytopenia is diagnosed.
8. Prothrombin index (PTI). This is a comparison between established norm blood plasma coagulation and parameters obtained from the patient. The indicator is expressed as a percentage. Normal numbers are considered to be 97-107%. Low values ​​indicate poor clotting properties, intestinal diseases, or a lack of vitamin K. Sometimes this effect is achieved by taking and acetylsalicylic acid. A change in PTI indicates the likelihood of thrombosis and liver disease.
9. D-dimer- These are remnants of the fibrin fiber enzyme. This indicator is very important when studying during pregnancy. General norm- 500 ng/l, but for a pregnant woman it is typical to exceed it several times. Excess D-dimer sometimes indicates diabetes mellitus, gestosis, and kidney disease.
10. Antithrombin-III. An increase indicates a serious risk of blood clots.
11. DIC syndrome. The coagulation system in the body works very intensively, which leads to its development. In pregnant women, this can cause endometritis, placental abruption, etc.
12. Plasma recalcification time outlines the entire coagulation process as a whole.
13. Antibodies to phospholipids. This autoimmune pathology may cause fetal loss due to placental insufficiency. More and more antibodies appear in the body, which can provoke a number of symptoms inherent in.
14. Plasma tolerance to . To carry out the test and identify the corresponding indicators, heparin is used, obtained by studying the time of plasma recalcification. If tolerance decreases, hepatitis or cirrhosis is suspected, and if tolerance increases, prethrombosis is often diagnosed.

There is no need to independently study the coagulogram, since the specialist takes into account many factors when deciphering the data.

Sometimes an increase or decrease in certain indicators does not indicate the development of dangerous diseases, which is also important to consider.

The table below shows the normal blood coagulogram in pregnant women:

average cost

The cost of performing a blood coagulogram depends on the equipment and the scope of services. For example, a basic study can cost between 700 and 1,500 rubles, and an advanced study can cost 3,500 rubles.

Pregnant women compulsory medical insurance policy they do not pay for a hemostasiogram, since this examination is included in the category of mandatory for them.

Experts will talk about the importance of a coagulogram during pregnancy in the video below:

Doctors prescribe many different tests for every sick person. However, not everyone knows what they are all intended for. This article will discuss what a blood coagulogram is.

Designation of concepts

Let's understand the basic concept that will be actively used in this article. So, a blood coagulogram is an analysis of its homeostasis. In other words, the blood clotting system itself will be examined.

Blood clotting is the process of its thickening from a liquid consistency to the state of a so-called clot. This is a natural phenomenon, a certain protective reaction of the body to blood loss. The coagulation process itself is regulated by such important systems as the endocrine and nervous systems.

Preparing for tests

How to donate blood for a coagulogram, what do you need to know for this? First of all, it is worth saying that it is necessary to prepare for this procedure in advance. Only in this way will the results obtained be correct and will be able to indicate either the presence of problems or their absence.

1. Before taking the test, you should not eat for 10-12 hours. That is why this analysis take it in the morning. The patient is told not to have breakfast. That is, the analysis is taken on an empty stomach.
2. In the evening, on the day before donating blood, the patient is recommended to have a light dinner without fatty foods, smoked foods, or fried foods.
3. You can drink it in the morning before the test. However, only clean water without gas. Coffee, tea, juices are prohibited.
4. If the patient smokes, you should abstain from cigarettes for an hour before taking the test.
5. Doctors recommend: before taking a blood test for a coagulogram, you need to drink a glass clean water(200-250 ml).
6. On the day of the test, it is not recommended to overexert yourself both physically and emotionally.
7. Immediately before blood sampling, the patient should be calm and balanced. The pulse should return to normal.
8. If a person is taking medications that affect blood clotting, be sure to tell doctors about this.
9. If the patient does not tolerate the blood sampling process well, specialists should also be warned about this.

How and from where?

If a patient is prescribed a coagulogram, where is the blood taken from in this case? The sample will be taken from a vein. The resulting liquid is placed in test tubes (up to a certain mark), into which a preservative was added the day before.

1. The puncture site is pre-treated with alcohol (but not ether!).
2. The puncture is made only after the alcohol has completely dried.
3. It is best not to apply a tourniquet before drawing blood. The thing is that constriction of a human limb activates blood clotting, in which case the results may be distorted.
4. The first 5-6 drops of blood are not allowed into the test tube (they are blotted with a swab), as they may contain tissue thromboplastin.

Important: if the patient is prescribed several tests, blood is taken at the very beginning for a coagulogram, fibrinogen and prothrombin index.

Indications

When can a blood coagulogram be prescribed?

1. If the patient has problems with blood clotting.
2. This analysis is mandatory for patients undergoing surgery.
3. If the patient has uterine or other bleeding.
4. This analysis is needed for those patients who are being treated with anticoagulants.
5. If the patient has a history of heart attack or stroke.
6. This analysis is needed for people who have problems with the liver or vascular function.
7. At autoimmune diseases It is also necessary to donate blood for a coagulogram.
8. The test is often prescribed for pregnant women.
9. The indication for its delivery is varicose veins veins of the lower extremities.

Clotting time

Among the main indicators of a coagulogram, blood clotting time is distinguished. So, doctors determine how long the blood will flow, for example, from the moment of the cut until it stops completely. Normal interval:

• from 30 seconds to 5 minutes, if we are talking about capillary blood;
• about 10-15 minutes if it is venous blood.

This indicator allows you to judge how well platelets cope with their task. When the duration of bleeding from a wound may be increased:

1. If there is a lack of vitamin C in the body.
2. If for a certain reason the platelet count is reduced.
3. If the patient long time takes anticoagulants - for example, Aspirin.
4. For hemophilia or liver disease.

Blood may clot faster than the presented indicators if the patient takes hormonal contraceptives or there has been heavy bleeding before.

PTI

This is the prothrombin index. This indicator is very important, as it allows you to monitor the condition of the liver. Its normal value: 80-120%. PTI may increase in the following cases:

1. If a woman is pregnant (this is normal).
2. If the patient takes contraceptives orally.
3. If there is a risk of blood clots that are dangerous to the body.

If the PTI is below normal, this is fraught with bleeding for the patient. And in order for this indicator to be within standard limits, the patient must take vitamin K.

Thrombin time

What other indicators are important if a patient is prescribed a blood coagulogram? This is thrombin time. Normally it is 15-20 seconds. During this period, the process of converting fibrinogen into fibrin is measured. If this indicator can be obtained over a longer period of time, this may indicate the following problems:

• there is an excess of fibrinogen in the patient’s blood;
• there is a lack of protein in the body;
• severe renal failure developed.

If the patient is treated with a drug such as Heparin, this indicator must be strictly monitored. How is it designated in medicine? Blood coagulogram - INR, i.e. international normalized treatment.

APTT

This abbreviation stands for “active partial thromboplastin time.” It is worth saying that this is the most sensitive indicator of blood clotting. It demonstrates how quickly a blood clot forms after calcium chloride or other components are added to the plasma. The normal rate is 30-40 seconds. If the blood coagulogram (APTT) is higher than normal, this may indicate that the patient has a diseased liver or a lack of vitamin K in his body.

AVR

This activated time recalcification. This indicator allows you to find out how one of the stages of blood clotting occurs. Normal data: 50 to 70 seconds. If the readings are lower, this may indicate that the patient has a thrombophilia condition. If the time period is significantly longer, the reason may be the following:

• a significant decrease in the number of platelets in the blood;
• heparin therapy;
• one of the critical conditions: trauma, burn, shock.

Fibrinogen concentration

Normal value: from 5.9 to 11.7 µmol/l. It may decrease when various diseases liver. Increases in the following situations:

1. If the patient has malignant tumors.
2. For acute infectious diseases.
3. With a lack of thyroid hormones.

RFMK

This indicator is deciphered as follows: “soluble fibrin-monomer complexes" This is a marker of intravascular coagulation. It demonstrates changes in fibrin under the influence of thrombin and plasmin. Upper limit of normal: 4 mg/100 ml. It can change depending on the same reasons as fibrinogen.

Thrombotest

What does a blood coagulogram show if an indicator such as thrombotest is considered? It allows you to detect the amount of fibrinogen contained in the patient’s blood. Normal indicators: thrombotest grade 4 or 5.

Tolerance to plasma heparin

This indicator indicates the amount of thrombin in the blood. In this case, it will be possible to see how long it takes for a fibrin clot to form in the blood plasma (this should happen after heparin is introduced into the blood). Normal values: 7-15 minutes. Blood resistance to heparin decreases if the patient has liver problems (15 minutes or more). Hypercoagulation (which is typical for pregnant women), the presence cancerous tumors, diseases of cardio-vascular system, and postoperative period- these problems can cause indicators in which blood tolerance is less than 7 minutes.

Fibrinolytic activity

This indicator allows you to determine how much blood can independently dissolve blood clots. Fibrinolysin, which is found in the plasma and can break down the structure of the blood clot, is responsible for this. If a patient’s blood clots dissolve faster than normal, then he or she is at risk of bleeding.

Duke indicators

If the patient needs to undergo a blood test for a coagulogram, the duration of bleeding according to Duke can also be examined. In this case, the patient's finger will be pricked. The penetration depth of the lancet (special instrument) is 4 mm. Then, approximately every 20-30 seconds, drops of blood will be removed from the patient using special paper. After removing one drop, the doctor times the time during which the next one appears from the wound. In this way, the patient's capillary blood clotting is checked. Ideally, this indicator should fluctuate between one and a half to two minutes.

Fibrinogen

I would like to remind you once again what a coagulogram examines - blood clotting. It is very important to study a protein synthesized by the liver called fibrinogen. Under special conditions, it is synthesized in the hematopoietic system into such an important substance as fibrin. Normal levels of fibrinogen in the blood healthy person: 2-4 g/l. When indicators can be reduced:

1. If a woman has toxicosis while carrying a baby.
2. If the patient has cirrhosis of the liver.
3. In very severe forms of a disease such as hepatitis.
4. In case of failures in homeostasis.
5. If there is a lack of B vitamins or ascorbic acid in the body.
6. These indicators may decrease if the patient takes fish fat, anabolics or anticoagulants.

Fibrinogen levels exceed the norm in the following cases:

1. For acute infections.
2. For pneumonia.
3. In inflammatory processes.
4. While carrying a baby.
5. After childbirth.
6. After operations.
7. In case of heart attack or stroke.
8. After receiving burns.
9. As a consequence of taking hormonal contraceptives.

Important: fibrinogen B must be negative.

Blood clot retraction

When taking a blood coagulogram, the norm of this indicator should be from 45 to 65%. In this case, the decrease in the volume of the blood clot is studied, its reduction along with the release of blood serum. Indicators increase as a result of anemia. They decrease if the patient’s platelet count decreases or red blood cell count increases.

GRP

This indicator provides information about the time of plasma recalcification. Normal: from 60 to 120 seconds. This is one of the most important indicators of homeostasis. If the time is less than specified, we can say that the patient has hyperactive blood clotting.

A few words about children

It is important to say that in young patients some indicators will differ slightly from the norms presented above, while others will differ significantly. So, for example, the optimal amount of fibrinogen in a child’s blood is about 1.25-3.00 g/l. At the same time, in an adult it is 2-4 g/l. This test can be prescribed for children in the following situations:

1. Before surgery.
2. With frequent bleeding.
3. If there is a suspicion of hemophilia or other diseases that affect the circulatory system.

A few words about pregnant women

For women who are pregnant, this test is done three times in 9 months (once in each trimester). This is very important, since the hormonal system of a pregnant woman changes, which affects homeostasis (the changes are not pathological, but physiological, i.e. normal). Also, this study will help identify the threat of miscarriage or premature birth (which often occurs as a result of blood clots). In the first trimester, blood clotting rates may increase, but closer to childbirth they may decrease. All this is normal, because in this way the body tries to protect itself from possible bleeding and large blood losses. If the doctor is not satisfied with the results obtained, the woman will have to take this test again. If a pregnant woman is prescribed a coagulogram (blood test), the norm will be slightly different than that of a healthy person:

1. Thrombin time: 11-18 seconds.
2. Fibrinogen: 6 g/l.
3. Prothrombin: 78-142%.
4. APTT: 17-20 seconds.

If a woman is pregnant, it is very important for her to study an indicator such as prothrombin. Its deviation from the norm may indicate that the patient is at risk of pathological

With the continuous development of medicine, scientists have obtained many methods.

Test indicators help reveal a complete picture of a person’s health status, the presence of diseases, infections, pathologies, and the prevention of disease development.

One of the tests is a blood coagulogram.

What is a blood coagulogram?

Blood coagulogram is a test that shows blood clotting. In a broad sense, a coagulogram reveals platelet activity. Blood clotting is a particularly important indicator.

The blood clotting system is triggered in two ways: externally (outside the vessel, when a damaged area is detected) and internally (when blood cells are destroyed).

When the wall is destroyed blood vessel a protein is released, which signals the need to activate the defense mechanism. Nearby platelets quickly change their shape, adhere to each other, forming a mesh.

The site of injury is quickly clogged by the formed plexus, stopping the blood and preventing the penetration of harmful bacteria from the outside.

The medical name for this important process for the body is hemostasis (a process that includes all stages of coagulation up to the dissolution of the protective clot).

However, in any, even the most strong system failures are possible.

Why is it necessary to do a blood coagulogram?

Disease Prevention

Thrombosis is a disease in which, without the need for activation protective function, blood clots form.

Such blood clots are called emboli, the disease is thromboembolism.

Emboli can clog arterial vessels. The formation of obstruction (obstruction) by more than 90% causes a lack of oxygen (hypoxia), not to mention the accumulation of metabolic products. Brain hypoxia, for example, most dangerous diagnosis, often leading to coma, which results in death in 80% of cases.

Biochemical screening of the health status of the expectant mother and child

The analysis is especially important for a pregnant woman. A blood coagulogram is recommended for women who have:

• liver diseases;
• bleeding disorders;
• varicose veins;
• immune diseases.

Bearing a fetus is a natural process associated with the formation of the uteroplacental circulation. During pregnancy, the body prepares for blood loss, which affects the increase in some coagulogram parameters.

If the expectant mother has serious abnormalities in blood clotting, the doctor will prescribe treatment. Impaired coagulation that is not determined in time can lead to serious consequences - miscarriage and premature birth.

A blood coagulogram is necessary not only to identify abnormalities in the hemostatic system, but also to establish a diagnosis of patients in some cases.

How to prepare for the analysis?

A coagulogram does not require special preparation. However, there are points that it is advisable to observe in order to pass the analysis well:

• food intake – 8 hours before blood sampling;
• It is recommended not to eat fatty foods;
• drink only water;
• It is recommended not to smoke for an hour before the test;
• before analysis, you must try to calm down emotionally and physically;
• if the patient is prescribed a course of medication that is not related to the reasons for the blood coagulation test, it is necessary to notify the doctor about this;
• If you experience a feeling of malaise or dizziness during the test, you should immediately inform the specialist taking the tests.

Causes of high and low blood coagulogram values

Coagulogram values ​​above normal indicate:

• infectious-toxic and septic disease;
• intoxication of the body;
• atherosclerotic vascular lesions;
• endocrine pathology;
• the occurrence of disseminated intravascular coagulation (DIC syndrome), etc.

Coagulogram indicators are below normal:

• leukemia();
• vein thrombosis;
• various diseases internal organs( , digestive system);
• hereditary clotting defects;
• final phase of DIC syndrome, etc.

The listed diagnoses are few. It is important to remember that this is aggregate data. To identify the reason that violates the norms of hemostasis, it is necessary to decipher and specifically compare each indicator with the norm, taking into account the characteristics of the patient’s body.

Details about blood coagulogram parameters

• Fibrinogen (a protein produced in the liver and responsible for the final stage of blood clot formation):

Causes of low fibrinogen:

• donation, taking steroids, etc.
• chronically reduced level fibrinogen, impaired synthesis from birth;
• liver diseases;
• unbalanced diet.

Reduced protein concentrations characterize the inability to fully coagulate blood and a tendency to spontaneous bleeding.

Increased fibrinogen level:

• inflammatory processes, alas, the most varied - acute, infectious mononucleosis, etc.;
• massive tissue destruction (lung abscesses, gangrene, ulcers, etc.);
• tumor formation;
• , cerebrovascular accident;
• peripheral vascular diseases (arterial atherosclerosis, vascular damage due to diabetes mellitus, thrombophlebitis, chronic venous insufficiency);

Not always elevated or reduced rate fibrinogen indicates health problems.

A minor effect on the indicator in an adult can also be exerted by:

• smoking;
• taking hormonal-based contraceptives, estrogens;
• loads;
• stress;
• cholesterol;
• obesity.

In adults, the norm ranges from 2-4 g/l, in pregnant women up to 6 g/l, in children the fibrinogen content is 1.25–3 g/l.

• (aPTT):

Characterizes the period of time required for the platelet reaction. An increased thromboplastin time characterizes a tendency to uncontrolled bleeding and prolonged blood clotting.

Using the INR indicator, doctors evaluate the effect of prescribed medications.

• D-dimer:

After the destruction of the blood clot (during the breakdown of fibrin), a protein fragment – ​​D-dimer – is observed in the blood. After restoration of the affected part of the body, the protein plasmin is formed, which destroys and destroys blood clots.

The number of fragments in the blood allows us to identify the work of two processes at once: the formation of blood clots and their dissolution (fibrinolysis). A balance is required between thrombus formation and fibrinolysis. Lack of balance informs hemostasis.

The norms for indicators in adults and children are presented in the table below. Deciphering the blood coagulogram will reveal the discrepancy between each indicator: what it is and how much it should be.

• Soluble fibrin-monomer complexes (SFMC):

Few people have heard of the RFMK blood test. The RFMC blood test is an additional indicator, it is included in the coagulogram and is considered important laboratory analysis characterizing the hemostasis system. Many experts consider the RFMK blood test to be an indicator of thrombinemia (the formation of small blood clots) and the onset of DIC.

Blood coagulogram indicators: norms for adults and children Table

To summarize, I would like to note: an accurate blood coagulogram can be interpreted by good specialist- doctor.

Only he will be able to identify deviations from the norm for each patient with high accuracy.

The medical history of each patient is a separate situation that requires detailed consideration.

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