Hemostaziogram: what is it like to take, decipher the indicators
Quite often during the diagnosis of a disease, doctors recommend that their patients undergo a study called a hemostasiogram. What it is? What can you learn with this test? How and when should I take tests? How much will the procedure cost? Answers to these questions are sought by every person who is faced with the need to undergo such research.
Hemostaziogram: what is it?
Modern diagnostics has in its arsenal a lot of different tests and examinations, through which you can establish an accurate diagnosis. One of the important studies is the hemostasiogram, it is also a coagulogram. What is this analysis and in what cases it should be done?
This is an important study that allows you to study the processes of blood clotting. The hemostatic system performs two functions at once: on the one hand, it maintains blood inside the vessels in the liquid state, and on the other hand it reacts to vascular damage and triggers the mechanisms of stopping bleeding. Naturally, disrupting the operation of such a system leads to dangerous complications, which for some patients end up lethal.
Determine the presence of failures in a similar scheme and helps coagulation. What kind of analysis is this, we sorted it out. Now we need to consider other information about the study.
When are tests recommended? Of course, ideally, from time to time, each person would have to donate blood for the analysis of clotting processes. But at present, this test is carried out with certain indications:
- Severe liver disease.
- Diseases of the endocrine system( the level of hormones also affects the processes of blood clotting).
- Pathology of the urinary and cardiovascular system.
- The patient has some autoimmune diseases.
- Regular nasal bleeding, severe bleeding gums.
- Varicose veins.
- The patient has bad habits, chronic alcoholism.
- Propensity to form large bruises even with the slightest bruises.
- Poor results from previous coagulograms.
- Hemostasiogram is extremely important during pregnancy. It is prescribed to women who have hypertension of the uterus, gestosis, intrauterine growth retardation and other complications. Also, indications are multiple pregnancy, the presence of a history of miscarriages.
- The study is also conducted before surgery, because a clotting disorder can lead to the death of the patient during surgery.
Extended and conventional hemostasiogram: what is the difference?
In most cases, patients are assigned a standard analysis, which includes the determination of indicators such as thrombin and prothrombin time, the level of fibrinogen and prothrombin. Also, a specialist counts the number of platelets in the peripheral blood, determines MNO and RCMF( soluble complexes of fibrin monomers).
Sometimes the so-called enlarged haemostasiogram is performed. What it is? In fact, this is the same study, but in addition to the above indicators, the lab assistant determines some other parameters, including antithrombin III, lupus anticoagulant and D-dimer. Since the analysis is more labor-intensive, its value in the clinic is slightly higher.
Preparation for the
test In order for the coagulogram( hemostasiogram) to be reliable, some preparation is necessary. Sampling is carried out on an empty stomach. Moreover, patients are not recommended to eat for 8-12 hours before the procedure. Only drinking pure still water is allowed.
In addition, the day before the test, you need to limit physical activity, avoid stress, have a good rest and sleep. From the use of alcohol and some medications( in particular, aspirin, which is known to dilute the blood) should be abandoned at least a week before the procedure. If there is an urgent need to take any medications during this period, their list should be provided to the treating doctor, as many drugs affect the results of the analysis.
Women are not recommended to take tests during menstruation. During this period, the body loses some blood, which can cause a short-term increase in its coagulability and, accordingly, distort the real data on homeostasis.
How to pass the test?
There is an important question for every patient who is assigned a hemostasiogram: how to take the analysis? It was already mentioned that the delivery of samples should be performed on an empty stomach, which means that the procedure is prescribed for the morning hours( usually from 8 to 11 am).
Blood on the haemostasiogram is taken from the vein. The procedure is standard - with the help of a sterile syringe, the laboratory worker takes necessary blood volume( takes several minutes).After that, the samples are sent to a laboratory study. By the way, in most cases, the results of the analysis are ready after 2-3 hours after delivery.
Where are these studies conducted?
Where to make a hemostasiogram? A similar procedure is carried out in almost every clinic and medical center, so there will be no problems with finding the point of delivery of tests. On the other hand, it is better to carefully read the reviews about the work of this or that laboratory, because the further course of therapy depends on the results of the study.
Hemostasiogram: decoding of
indices After the analysis the patient, as a rule, receives the form in the form of a table, where the parameters found during the study are entered. Results should be shown to a specialist as soon as possible, because he can determine what your hemostasiogram testifies. Decoding of indicators is a difficult matter, it's impossible for a patient to figure out all the figures in one's own figures. On the form, as a rule, the following indicators are recorded:
- APTT - activated partial partial thromboplastin time - allows evaluating the work of the internal blood clotting pathway. Prothrombin time - this indicator allows you to evaluate the external way of blood clotting( this is the time for which plasma begins to fold with the addition of tissue factors, prothrombin and calcium, usually 15-17 seconds).
- INR( international normalized ratio) - during the research the laboratory assistant compares the processes of blood coagulation of the patient with a special plasma, the indicators of which correspond to international standards.
- The level of fibrinogen, a protein that, when the coagulation process starts, turns into fibrin( its concentration is 2-4 g / l).
- Thrombin time is a period of time that is necessary for the formation of fibrin and fibrinogen( normal - 11 to 18 seconds).
- The number of platelets in the blood( normally from 150 to 400 thousand cells per 1 μl).
- The presence of D-dimer( this figure should not exceed 248 ng / mg).
Correctly conducted research helps the doctor to learn about the content of a specific prothrombin protein in the patient's blood. This is an important component of the blood clotting process, since it precedes the substance, which triggers the formation of a blood clot and, accordingly, stops the bleeding. This protein is formed in the human liver( vitamin K is needed for its synthesis).Deviations in the level of prothrombin may indicate violations of the liver and digestive tract.
Prothrombin time is another important indicator that makes it possible to determine the haemostasiogram. What it is? In fact, this is the length of time for which blood "reacts" to a wound and produces a fibrin clot. In a healthy person, this process takes place in 10-18 seconds.
Quite often during the research, the laboratory assistant not only measures the time, but also determines the prothrombin index. In norm this indicator is not less than 93%.Decrease in this indicator indicates violations of the liver. Sometimes it is associated with a violation of the digestive tract, a deficiency of vitamins K, the use of a large number of diuretics or drugs containing acetylsalicylic acid. This also indicates a risk of bleeding. But an increase in the index to 106% and higher indicates a tendency of the blood to form blood clots.
Thrombin time: normal and abnormalities
This is another extremely important factor that makes it possible to determine the haemostasiogram. What it is? Thrombin time is the time that is needed for inactive fibrinogen to become fibrin. In a healthy person, this indicator is 15-18 seconds.
In addition, during the laboratory test it is necessary to determine the content of fibrinogen in the blood. The normal content of this protein in the blood is 2-4 g / l. It is worth saying that the level of fibrinogen can sometimes increase. This is observed, for example, in the last month of pregnancy, and also after a stroke, a heart attack, in the presence of burns, thyroid disease, long-term use of hormonal contraceptives. In such cases, the increase in fibrinogen is considered normal to 6 g / l.
A strong decrease in the amount of this protein is observed against a background of severe liver diseases( including hepatitis and cirrhosis), a deficiency in the body of B vitamins and ascorbic acid.
One of the most important parameters for this test is APTTV.This is the time for which a blood clot can form when the chloride is added to the plasma. Normally it takes about 30-40 seconds. This indicator most accurately characterizes the work of the hemostasis system.
Blood clotting disorders
Naturally, there are a huge number of pathologies that this analysis can indicate. Hemostasiogram helps to identify some important bleeding disorders:
- Hypocoagulation is a condition that is accompanied by a decrease in the rate of coagulation, which is fraught with frequent bleeding( sometimes even from a minor scratch).
- Hypercoagulation is a pathology characterized by an increase in the degree of clotting of the blood. It folds even in the absence of injuries and injuries.
- Thrombophilia is a condition in which the tendency to form clots increases. Naturally, this pathology is very dangerous and in the absence of therapy can lead to death.
Why conduct a pregnancy test?
During pregnancy, this analysis is very important, as it helps diagnose existing complications and possible risks in time. For example, a doctor can determine if enough oxygen and nutrients are received by a child with blood, whether there is a chance of blood clots or massive bleeding during labor. As a rule, the analysis is carried out immediately after the patient is registered in the hospital, and then at the 22nd and 26th week.
How much does the analysis cost?
Naturally, for many patients, the important point is the cost of a survey. So how much will the hemostasiogram cost? The price, of course, depends on many factors. For example, in consideration it is necessary to take the qualification of the specialist and the financial policy of the medical center, the services of which you decided to use. The cost of basic research varies within very wide limits - from 400 to 1300 rubles.
Extended hemostasiogram, of course, costs more - about 3000-4000 rubles. Of course, the numbers in this case are not too small. But you need to understand that the results of the tests will help the doctor diagnose the disease correctly in time. By the way, in some clinics this research is free of charge.
The results and their reliability depend on the qualifications and experience of the laboratory assistant who conducts the research. Therefore, you need to carefully approach the choice of a specialist and a medical center. Remember that only the doctor can correctly decipher the results of the tests and assess the condition of the patient's body.