Coagulogram – what is it?
A blood coagulogram, or hemostasiogram, is the result of a set of blood parameters, which can be used to determine the degree of its coagulability. Clotting of blood has a protective function, since when the integrity of the blood vessel is violated, it stops bleeding and prevents large blood loss. The analysis also has a different name – blood for a hemostasiogram or coagulation hemostasis.
Hemostasis is a special system in the body, the main task of which is to keep blood in a liquid state in the vessels, stop bleeding in case of damaged vessel walls and prevent the formation of blood clots. Blood clotting is not the only mechanism aimed at maintaining the body and reducing blood loss. The primary functions of hemostasis are provided by platelets and special properties of blood vessels. That is why it is important to understand what a coagulogram is and what it is prescribed for.
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Expanded blood coagulogram
The indicators that are included in the blood test for coagulogram are relative. For the completeness of the study in the expanded coagulogram, it is important to evaluate each factor of blood coagulation. There are 13 of them, and an omission in the analysis of at least one of them can lead to serious consequences.
An extended coagulogram is a collection of many indicators; such a study is carried out mainly in the diagnosis of specific hereditary diseases. Such a study can not be carried out by every laboratory, because it requires the presence of special expensive equipment.
In this regard, in practice, a set of basic indicators is often investigated, the level of which, in combination with other analyzes of primary hemostasis, will make it possible to judge the general coagulation properties. This also requires knowing the total platelet count, bleeding time, platelet aggregation and clot retraction.
For a more accurate diagnosis of some diseases and in the treatment of low or excessively high blood clotting, it is required to obtain the results of all indicators, to determine the components of the blood.
Expanded coagulogram includes obtaining data on:
retraction of a blood clot,
plasma tolerance to heparin,
Abbreviated coagulogram – what is this analysis?
A reduced set of indicators includes:
blood clotting time,
activated partial thromboplastin time (APTT),
Thrombin time is calculated by adding an active thrombin solution to the plasma. The indicator is measured in seconds and indicates the ability to clot in the presence of a solution. Normally, this figure is 15-18 seconds. An increased indicator can be in hereditary pathologies, indicating an increased value of blood coagulation inside the vessels and significant liver damage. This method is often used in drug treatment with fibrinolytics and heparin.
The method for determining the retraction of a blood clot is similar to the method for determining the thrombin time, it allows you to determine both the coagulability of the blood clot and the degree of its compression, the rate of the indicator is expressed in qualitative and quantitative values. The qualitative indicator can be 0 or 1, indicating the absence or presence of clotting of the clot. The norm of the quantitative value is 40-95%. A decreased value can be caused by thrombocytopenia, an increased one can be evidence of anemia.
Thrombotest – assessment of the presence of fibronogen in the blood. Normal thrombotest is grade 4-5. The fibrinogen level should be between 2,7-4,013 grams. If the level of this protein increases, the blood becomes thicker, and this can lead to the onset of the process of thrombus formation. In pregnant women, this rate may fluctuate slightly.
In the process of determining the plasma tolerance to heparin, it is found out how quickly a fibrin clot can form when heparin is added to the blood. Ideally, this process should take 7-15 minutes. Decreased heparin tolerance is an extended period of time for clot formation, which may indicate liver disease. If the coagulogram of this indicator is less than normal, then this may indicate hypercoagulation.
The indicator of fibrinolytic activity reveals the ability of the blood to independently dissolve the formed blood clots within a certain period of time. The value is significantly influenced by the presence of fibrinolysin in plasma. 183-263 minutes is considered the norm. Indicators below normal indicate an increased degree of bleeding.
In what cases is a coagulogram indicated?
There are many situations in life in which it is extremely important to know the clotting indices, therefore such a study is of significant importance and is indicated for:
signs of bleeding, frequent hematomas under the skin from minor bruises,
preparation for various kinds of operations,
various diseases of the blood vessels,
after heart attacks and strokes,
after implantation of artificial heart valves to assess the risk of emboli,
identifying the reasons for the decrease in the immune functions of the body’s defense,
monitoring the condition in women during pregnancy and before childbirth. During this period, the indicators may fluctuate slightly, but this can be explained by hormonal changes in the body. The analysis allows you to determine whether there is a likelihood of complications during childbirth, because some deviations from the norm can cause a miscarriage, premature placental abruption, or lead to severe bleeding. To monitor the condition of a woman during pregnancy, an analysis must be taken every trimester, while, upon receipt of results, an increase in coagulability is often noted – this way the body reduces the risk of possible blood loss.
A blood clotting test is also necessary for the correct prescription of drug treatment when using drugs that stabilize various parameters of the body. In case of cardiac arrhythmias, varicose veins, stroke and coronary heart disease, a hemostasiogram analysis is performed to monitor the action of drugs and timely diagnose possible deviations.
How to take a blood coagulogram test?
It is important to follow some recommendations when submitting an analysis to obtain reliable data. So how to take a coagulogram?
It is necessary to donate blood on an empty stomach, that is, you do not need to eat 8-12 hours before the study.
It is forbidden to consume alcohol, including low-alcohol drinks, beer.
It is not recommended to drink coffee, tea and juices with a high content of concentrates and sugar 1 hour before the analysis.
Physical activity on the body should be excluded 2-3 days before the test.
When taking any medications (especially anticoagulants), you should warn the attending physician about this, it may be necessary to wait 1-2 weeks for them to stop acting and remove from the body.
It is not worth doing an analysis during menstruation, since the blood during this period in women is thinned, so it will be almost impossible to determine the exact time of its clotting. The best time to take this test is in the middle of the cycle.
You should not take a coagulogram analysis against the background of strong feelings and general fatigue. In this case, it is better to wait a while, as this may affect the results of the coagulogram and its interpretation. It is necessary to donate blood for a coagulogram in the morning before breakfast, after sleep and good rest.
If you feel dizzy at the sight of your own blood or injections, be sure to warn the nurse about this.
Deciphering the results of the coagulogram
To determine it, take 2 ml of blood from the cubital vein. After that, without adding any substances, the blood is divided equally into 2 test tubes, which are placed in water, the temperature of which corresponds to the temperature of the human body, and a stopwatch is turned on. The tubes should be tilted slightly and watch the moment a clot occurs. A reliable result is considered to be the average value obtained from 2 tubes, while the norm is an indicator of 5-10 minutes.
If the received result exceeds 10-15 minutes, this may indicate:
deficiency of prothrombinase,
vitamin C deficiency
An indicator above the blood clotting rate indicates hypercoagulability and leads to a greater formation of platelets, which, in the absence of bleeding, can lead to clogging of blood vessels – thrombosis or thromboembolism.
If in the expanded coagulogram the value of blood coagulation is reduced, then this condition is called hypocoagulation. In this case, the blood does not coagulate well or does not coagulate at all, which can lead to large blood losses even with minor vascular damage. Latent internal bleeding is especially dangerous, since it is not always possible to recognize them in a timely manner.
To diagnose diseases that can affect any indicator of blood clotting, sometimes blood tests are not enough, and even an extended hemostasiogram cannot fully clarify the situation. The decoding of the blood coagulogram should be carried out exclusively by the attending physician, and when assessing the indicators, it is necessary to compare other groups of tests, take into account the biochemical blood test and have knowledge of specific changes in drug treatment. Therefore, having received blood tests for coagulability, you should not independently evaluate the results, and even more so take any measures aimed at stabilizing them.
Determination of prothrombin time is almost the same as for coagulation, with the exception of the addition of calcium chloride solution and thromboplastin solution to the blood. The blood clotting rate is 12-20 seconds. A deviation of the indicator upward when using this technique may indicate problems in the synthesis of the enzyme prothrombinase. This can lead to chronic liver diseases, a lack of vitamins in the body, and dysbiosis.
High values of the coagulogram may indicate the intake of indirect coagulants, such treatment needs constant monitoring. The dosage is selected in such a way that the indicator increases by no more than 2 times. Hormonal contraceptives can also increase the prothrombin index.
ATCP is a plasma reaction to the addition of erythrophosphatide and cephalin, which helps to establish clotting deficiency, and is also considered the most sensitive indicator. The normal APTT is 38-55 seconds. If the value is less than the minimum threshold, then blood clots may form.
The method of determination is based on the property of plasma to turn into fibrin after adding special substances to it. After conversion, the fibrin strands are weighed. This allows you to get a quantitative indicator. The norm is a value in the range from 5,9 to 11,7 μmol per 1 liter of blood.
A low indicator may indicate congenital diseases – fibrinogenemia or significant liver damage. An indicator above the upper limit of the coagulogram norm may indicate:
the presence of an infectious disease,
the development of malignant tumors,
the development of acute or chronic inflammatory processes,
thromboembolism, taking into account the totality of the data obtained from other studies,
disruption of the thyroid gland.
In newborns, this indicator is significantly lower than in adults, the coagulogram rate ranges from 1,25-3,0 g/l.