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A coagulogram is a blood test that assesses its clotting ability. A coagulogram is one of the obligatory tests ordered before the surgery, but the indication for its performance is also gastrointestinal bleeding or very heavy menstruation. Check in which other cases a coagulogram should be performed, what the test is about and how to read its results.

Coagulogramisblood test , the purpose of which is to determine the number of platelets (thrombocytes) responsible for its clotting. Normal blood platelet count ranges from 150,000 to 400,000 / mm³ of blood. Platelet count over 400,000 / mm³ of blood indicates thrombocytosis. Having too many platelets in your blood makes them stick together more easily. As a consequence, blood clots can form and clog blood vessels. Conversely, a low level of thrombocytes (less than 150,000 / mm³) usually causes multiple bleeding. This is known as thrombocytopenia.

Coagulogram - indications for the test

Coagulogram is one of the mandatory tests ordered before surgery. They are also performed when there is a justified suspicion of a blood clotting disorder, indicated by:

  • prolonged bleeding after injury
  • repeated bleeding from the nose, gums (e.g. when brushing teeth) or digestive system
  • too heavy periods or extra-menstrual bleeding
  • bruises that appear even after minor injuries
  • appearing petechiae on the skin and mucous membranes

Coagulation testis also performed when the liver disease is suspected, and also when the patient is taking medications that may prolong the coagulation process.

In addition, a coagulogram is performed in people undergoing anticoagulation treatment (including after heart and blood vessel operations, with some cardiac arrhythmias, suffering from venous thromboembolism).

Important

A referral for a coagulogram should also be requested by women who have just stopped using oral hormonal contraception and are planning to become pregnant soon. Why? The estrogen contained in contraceptive pills causes the blood to thicken, and thus - promotes its formationblood clots.

The price of a coagulogramin a private diagnostic laboratory is approximately PLN 50.

Coagulogram - how to read the test results?

Blood clotting testincludes the followingparameters :

1. Coalion-Kephalin Time (APTT) - partial thromboplastin time after activation:

  • norm: 28-34 sec.(depending on the laboratory)
  • above normal: congenital deficiency of factor VIII (haemophilia A), IX (haemophilia B), XI (haemophilia C), afibrinogenemia, hypo- and dysfibrinogenemia, some forms of von Willebrand disease, presence of coagulation inhibitors (heparin, degradation products) fibrinogen, circulating anticoagulants)
  • below normal: time reduction suggests hypercoagulability or technical errors in blood collection

2. Prothrombin time (PT), or thromboplastin time, is a measure of the extrinsic prothrombin activation system

  • standard: 13-17 sec. or 0.9-1.3 INR (2-4 INR therapeutic range) or 80-120% (Quick indicator)
  • above normal: congenital deficiency of factors II, V, VII, X, chronic diseases of the liver parenchyma, vitamin K deficiency, disseminated intravascular coagulation (DIC), leukemia, uremia, Addison-Biermer disease
  • below normal: shortening the prothrombin time may indicate, inter alia, for thrombosis and thrombophilia,

3. Thrombin time (TT)

  • standard: approx. 15-20 sec.
  • Above Normal: Disseminated Intravascular Coagulation Syndrome, Cirrhosis And Other Liver Diseases, Treatment With Thrombin Inhibitors (Heparin)

4. The batroxobin time (reptylase - RT) is the time of plasma coagulation after activation with the thrombin-like enzyme - the reptylase

Norm: 16-22 sec.

5. Fibrinogen is an α2-globulin synthesized in the liver and is involved in the formation of a clot

  • norm: 1.8 - 3.5 g / L
  • above normal: kidney diseases (nephrotic syndrome, glomerulonephritis, hemolytic-uremic syndrome), heart attack and stroke, neoplastic diseases, thrombocytopenic purpura, collagenosis, use of certain medications, including oral contraceptives

IMPORTANT! The concentration of fibrinogen is physiologically elevated during menstruation and during pregnancy.

  • below normal: congenital deficiency of fibrinogen, liver diseases (fulminant hepatitis, cirrhosis, liver necrosis, hepatic coma), disseminated intravascular coagulation syndrome (DIC), fibrinolytic defects (haemorrhagic, post-traumatic, burns, acute promyelocytic leukemia, cancer)

6. Antithrombin III (AT III) is a natural glycoprotein that is produced in the liver and is an inhibitor of serine proteases

  • norm: activity: 75-150%
  • above normal: viral hepatitis, vitamin K deficiency, treatment with anabolic steroids. It also appears in kidney transplant patients
  • below the norm: incl. liver damage, kidney failure, neoplastic disease, vascular thrombosis, pulmonary embolism

Plasma recalcination time (CK), the clotting time of the plasma after calcification, should not be determined due to the low sensitivity and specificity of the test.

Based on:

Laboratory diagnostics , under ed. Szutowicz A., Raszei-Specht A., ed. Medical University of Gdańsk, Gdańsk 2009

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