Among the markers in blood tests that can detect pathological processes on early stages, the leading place is occupied by prothrombin according to Quick. In medicine, this indicator is used to assess the time of blood clotting, as well as to study performance digestive system(intestines, stomach, liver).
Quick prothrombin shows the rate of blood clotting
Functions of prothrombin
Prothrombin (PT) is a protein of complex structure, the synthesis of which is carried out in the liver and necessarily with the help of vitamin K. important function- is responsible for the normalization of plasma viscosity.
Determination of the level of prothrombin
To determine the processes of blood coagulation, it is used special analysis- coagulogram.
This research method is also called the prothrombin test, which includes the following indicators:
- prothrombin according to Quick (named after the scientist A. Quick, who was the first to suggest using PT to assess blood clotting) - comparison of the patient's results with standard plasma parameters (determined as a percentage);
- prothrombin time (PTT) - the time during which a blood clot forms in the blood to stop bleeding;
- prothrombin index(PTI) - characterizes the degree of blood clotting;
- international normalized ratio (INR) - the ratio of the patient's PTV level to the standardized PTV.
The main indicators of the coagulogram
The Quick marker prothrombin is used much more often than PTT and PTI. This is due to the low universality of the latter indicators, which makes it impossible to compare the values obtained in different laboratories.
Indications for research
Prothrombin test shows clinical picture blood conditions and can be assigned to a patient in the following situations:
- suspicion of the development of pathological changes in hematopoiesis;
- abnormalities in the metabolism of vitamin K (lack or excess important substance in organism);
- serious liver malfunction or pathological changes in the gastrointestinal tract;
- the formation of thrombosis due to the destruction of phospholipids by their own immunity antibodies (antiphospholipid syndrome);
- suspicion of a malignant blood pathology.
A prothrombin test is prescribed when antiphospholipid syndrome appears.
An indication for determining the level of PTV may be the period of taking anticoagulants during antithrombotic therapy (drugs for plasma dilution - Warfarin, Heparin). In this case, the analysis helps to monitor the function of blood clotting and adjust the dose of drugs.
How to prepare for the procedure
Due to the fact that a complex protein is formed in the liver, it actively reacts to any external stimuli (food, drinks, emotional and physical exercise). For the results of the prothrombin test to be reliable, the patient needs to properly prepare for the study.
- The material is taken on an empty stomach in the morning. It is important not to eat or drink anything from the evening until the moment of donating blood. It is allowed to use water without gas.
- Before the procedure (preferably within 48 hours), do not eat fatty and fried foods, give up flour food and alcohol.
- Do not smoke on the day of analysis.
- Try to limit physical activity 1-2 days before donating blood. At this time, avoid stress and emotional stress.
Two days before the study, you should not eat fatty foods.
Patients who regularly take vitamin K antagonists (warfarin) should take daily dose the drug 14-16 hours before the procedure. Otherwise, their reception can greatly distort the results of the study.
Prothrombin rates
The amount of prothrombin in the blood may differ depending on age and certain physiological conditions (pregnancy).
Table "Norms of prothrombin"
The amount of prothrombin in the blood of men and women is almost the same. Slight differences may be due to illness or physiological characteristics organism.
The optimal PTV value for women, men and children is within the range of 9-13 seconds. This is the rate of blood clotting rate.
During pregnancy, the amount of prothrombin in plasma may be slightly overestimated. Normal performance at this time, 82–152% are considered. If the percentage of PT is greatly increased or decreased, we are talking about pathological condition, which requires hospitalization and detailed examination.
Decoding the results
Any deviations in the activity of prothrombin indicate pathological processes in the body. Depending on the increase or decrease in the percentage of PT, specific diseases are identified.
Increased prothrombin
A high percentage of prothrombin according to Quick can be the result of the following conditions:
- increased synthesis of vitamin K;
- malfunctioning of the liver or the development of chronic diseases that led to a lack of blood clotting factors;
- oncological neoplasms in vital organs;
- damage to the venous walls and the formation of blood clots (thrombophlebitis or thromboembolism);
- disturbances in hematopoiesis;
- preinfarction state or directly myocardial infarction.
An increase in prothrombin may indicate the development of thromboembolism.
The increase in prothrombin in the blood can be affected by the regular use of clotting inhibitors (Heparin) or antibiotic drugs. In women, PT may increase due to hormonal contraceptives.Decrease in PT
Low plasma levels of a complex protein means that the patient has liver problems that may be causing insufficient vitamin K production.
In addition, a decrease in prothrombin can be a consequence of such pathologies as:
- malfunctions gastrointestinal tract(dysbiosis, inflammatory processes);
- congenital or acquired prothrombin deficiency;
- imbalance between the consumption of vitamins and their intake into the body (hypovitaminosis);
- increased blood viscosity (polycythemia).
A decrease in prothrombin indicates high viscosity blood
A strong decrease in PT indicates high risk bleeding. It is important to remember that the lower the value of the marker, the greater the likelihood of profuse blood loss, which can lead to the death of the patient.
How to increase prothrombin levels
In addition to drug therapy it is possible to increase the percentage of PT in the blood by adjusting the patient's lifestyle.
- exclude the use of alcoholic beverages and tobacco smoking;
- exercise ( hiking on fresh air, running, swimming);
- moderate physical activity;
- avoid stressful situations, control the emotional state.
Exercising will help increase prothrombin
During an increase in the prothrombin index in the blood, it is important to pay attention to nutrition.
- fatty, salty, smoked and fried foods;
- legumes (beans, peas), herbs and some vegetables (cabbage, beets, peppers);
- rich baked goods and flour products;
- buckwheat porridge.
Fish well increase the percentage of PT and fish fat, citrus fruits, onions and garlic, ginger. The diet should include raspberries, cranberries, strawberries, and figs. It is useful to eat oatmeal from cereals, drink from drinks green tea.
Folk remedies
Among the recipes alternative medicine there's a lot effective ways positive effect on blood clotting.
Medicinal raw materials (2 tbsp. L.) Place in an enamel pan, pour 500 ml of boiling water and boil in a water bath for 7-10 minutes. Strain the cooled broth and take 0.5 cups 3 times a day for a week.
A decoction of corn silk has a beneficial effect on prothrombin levels
Tincture with walnuts (shells)
Pour nutshells into a half-liter jar (do not ram) and pour vodka (moonshine) to the top. Leave the liquid to infuse in a warm place (without direct sunlight) for 7-10 days. Take the strained tincture 35–40 drops no more than 3 times a day.
To prepare the tincture, you need to use the shell of nuts
Knotweed and yarrow decoction
In equal parts, take herbs (1 tbsp. L.) And pour 0.5 liters of boiling water. Boil the vegetable liquid over low heat for 5-7 minutes. The broth should be drunk 1/3 cup in the morning, at lunchtime and before bedtime.
A knotweed decoction will help to increase the level of prothrombin.
Infusion of stinging nettle
Pour the crushed leaves of the plant (20 g) with boiling water (250 ml) and leave for 30-40 minutes. Healing liquid should be taken in the morning and in the evening for ½ glass.
Nettle will increase prothrombin levels
Treatment folk remedies not only increase clotting, but also stimulate metabolism, as well as improve the functioning of the heart and digestive system. The main thing is to observe all dosages.
How to lower prothrombin levels
The technique for lowering prothrombin coincides with the methods for increasing it. A healthy way life, playing sports, quitting smoking and alcohol, correct diet- the main companions of getting rid of high blood viscosity.
Folk remedies
Most effective methods Decreases in PT are considered recipes that contain honey, lemon, garlic or onions.
Healing mixture
Chop the onion (200 g) and garlic (100 g), add 110 ml of honey and 60 ml of lemon juice. Combine all components and mix until smooth. Use the finished drug for 1 tsp. several times a day.
A mixture of onions, garlic and honey is good at reducing prothrombin levels
Boil the beets well, peel and finely grate. Add 1 clove of garlic and 2 tbsp. l. vegetable oil, to mix everything. Beetroot salad must be present in daily diet for 7-12 days.
Beetroot salad with garlic is not only tasty, but also healthy
Apple-honey infusion
Wash and cut 3 medium apples into small wedges, place in a 1–2 liter thermos. Add 50 g of green tea and 15 ml of honey. Pour boiling water over everything and leave for 2.5 hours. Healing drink you need to drink during the day. A new infusion must be made every morning. The course of treatment is 5-7 days.
Apple-honey infusion must be drunk within 24 hours
Grind 50 g of ginger, add 1 tsp. green tea and pour 600 ml of boiling water. Add the juice of ½ lemon and a little honey to the infused and strained liquid. Drink the medicine 3 times a day.
Green tea with ginger helps reduce prothrombin levels
Recipes traditional medicine help to reduce blood viscosity and thereby increase or decrease the prothrombin index. Many recipes have some contraindications, so it is important to consult your doctor before using them. What to do in a given situation is decided by a specialist, choosing the treatment individually for each patient.
The rate of blood clotting and the level of its viscosity helps to determine prothrombin according to Quick. For this, a special blood test is performed - a coagulogram or a prothrombin test. It allows you to determine the pathological processes in the body in the early stages, and also helps to adjust drug therapy.
> Blood test for prothrombin, INR (prothrombin time)
This information cannot be used for self-medication!
Consultation with a specialist is imperative!
Prothrombin is one of important factors blood coagulation systems. It is formed in the liver with the participation of vitamin K and circulates in the blood plasma. When interacting with thromboplastin and calcium ions, prothrombin turns into thrombin, without which the formation of a blood clot is impossible.
Clinical diagnostic laboratories usually perform a prothrombin test, which is performed as a determination of prothrombin according to Quick, prothrombin time, international normalized ratio, or prothrombin index.
Prothrombin time (PTT) is the time interval during which blood plasma clotting occurs when a thromboplastin-calcium mixture is added to it. Measured in seconds.
The International Normalized Ratio (INR) is the ratio of the patient's PTT to the normal mean PTV. The analysis result is a coefficient (decimal fraction).
The prothrombin index (PTI) is the percentage of the coagulation time of the control blood plasma to the coagulation time of the plasma of the examined person. Expressed as a percentage.
The determination of prothrombin according to Quick differs from the previous test in that it uses several dilutions of the control plasma. This allows you to get more exact result(also in percentage).
All these indicators are used to assess the state of the coagulation system and determine the effectiveness of anticoagulant therapy.
In what situations is the study prescribed?
Changes in the listed indicators can occur both upward and downward in their values. Clinically, this is manifested by signs of increased or decreased blood clotting.
The reasons for increased coagulability are large fluid losses without its timely replenishment (vomiting, burns), taking hormonal drugs, violation of the permeability of the walls of blood vessels. Increased coagulability is observed with infections, vascular pathology, pregnancy, disseminated intravascular coagulation syndrome, after surgical interventions and is often manifested by various thrombotic complications.
With a decrease in blood clotting, bleeding of wounds increases, bruises form in soft tissues with minor injuries, nosebleeds often occur. Poor coagulability is characteristic of hemophilia, liver diseases. Patients who take anticoagulants for a long time suffer from it.
In all these cases, in mandatory a prothrombin test is prescribed.
Which doctors prescribe the test, and where can it be done?
A referral for research is issued by a therapist, surgeon, gynecologist, cardiologist, hematologist, oncologist, less often other specialists.
You can pass the examination in the laboratories of the diagnostic units medical institutions conducting a biochemical blood test.
What is the material for research, and how to prepare for it
The research material is blood. It is taken from a vein just before analysis into a special tube with an anticoagulant.
Before the examination, the doctor cancels drugs that change blood clotting. On the eve of the procedure, fatty and spicy dishes, alcohol are excluded from the diet. It is advisable to avoid emotional and physical stress. Blood sampling is performed on an empty stomach.
Study results are normal
Normally, the prothrombin time is 11 to 16 seconds. The INR coefficient is 0.85–1.35. The prothrombin index is in the range of 80-100%. Prothrombin according to Quick - 78-142%.
Disadvantages of the method
The disadvantage of the method is the presence of many reasons affecting the accuracy of the study results (lack of clear standardization of the thromboplastin used, the influence of other coagulation factors).
Clinical significance research
The method helps to diagnose the pathology of the blood coagulation system, to clarify the degree of its severity, to monitor the treatment. But prothrombin is only part of the body's hemostasis system, and a prothrombin test cannot reveal all violations. Therefore, in the presence of indications, it is necessary to carry out a comprehensive study of the blood coagulation system.
The prothrombin test is part of a blood clotting study - a coagulogram. In addition to the activity of this protein, indicators such as PI (prothrombin index, or PTI) and PT (prothrombin time) are also determined, which make it possible to assess the rate of clotting. The normal values of prothrombin in women, men and children, as well as the reasons for their deviation from the norm, are described in detail below.
Prothrombin - what is it?
Prothrombin is a high molecular weight protein compound involved in blood clotting. Its production takes place in the liver in the presence of many substances. In particular, vitamin K, a deficiency of which leads to the synthesis of the wrong molecules of prothrombin - they form blood clots that disrupt the movement of blood and can be fatal.
An analysis for prothrombin is needed to assess blood clotting, and the most accurate and universal method research is PK - prothrombin according to Quick. What it is? This test reveals the activity of prothrombin in the patient's blood compared to that in the control portion of plasma. This is the ratio of the patient's plasma clotting time to the time of this process in the sample.
The analysis is named after the scientist A. Quick, who proposed this method. In the test results, prothrombin according to Quick is expressed as a percentage. In the international nomenclature, it is assigned the number II, since it was discovered second after fibrinogen.
The Quick test is used not only to assess the activity of blood clotting elements, but also to study the functioning of the gastrointestinal tract and liver. The PC test is more versatile than the prothrombin time and prothrombin index tests.
List of indications for the analysis of prothrombin according to Quick:
- impaired blood clotting;
- liver disease;
- antiphospholipid syndrome - increased thrombus formation due to autoimmune causes;
- blood cancer;
- pathologies in which the production of vitamin K is impaired (blockage biliary tract, poor digestibility of food in the intestine, etc.).
Note: Vitamin K is produced by bacteria in the intestines and takes an active part in the formation of prothrombin. The rate of blood clotting is negatively affected by both its lack and excess.
A PC test is necessary to control the hemocoagulation system during the period of use of anticoagulants - Heparin, Warfarin and others. The structure of the blood and its composition also change with the onset menopause in women (after 45 years), which is a risk factor for the development of cancer. Therefore, at this age, it is especially important to regularly take a prothrombin test.
Prothrombin time - what is it?
Depending on the causes of bleeding, blood can begin to clot in two ways - internal or external. The first is activated if the vessels are damaged from the outside - as a result of a bruise, cut, scratch, bite, abrasion. The inner path works when the integrity of the wall blood vessel was disturbed from the inside - under the influence of toxins, pathogenic microorganisms, antibodies.
Prothrombin time is an indicator that reflects the work of the internal pathway in the hemocoagulation system.
It reflects the effectiveness of the "repair" of vessels that have been damaged by the connections circulating in the bloodstream. In the analysis results, the prothrombin time can be referred to as PT, ecombipl PT, or PT.
Prothrombin time increased, compared with the norm, under the following conditions:
- lack of vitamin K;
- the initial stage of disseminated intravascular coagulation;
- liver pathologies;
- taking drugs from the group of anticoagulants - Thromboass, Aggregal, Warfarin, Heparin and others;
- hemorrhagic diathesis of newborns;
- inflammation and blockage of the biliary tract;
- Zollinger-Ellison syndrome;
- impaired absorption of fat in the intestine;
- deficiency of coagulation factors -, prothrombin, AC-globulin, proconvertin and Stuart-Prower factor.
The lower the concentration of prothrombin in the blood, the higher the prothrombin time, because the process of blood coagulation is slower.
Prothrombin time lowered if the following conditions take place:
- pregnancy;
- DIC syndrome;
- high levels of antithrombin-III and other anticoagulants produced by the body;
- deviation from the norm of hematocrit - the ratio of the volume of blood cells to the volume of plasma.
The low prothrombin time during the test can be due to the long storage of plasma before the study and violations during blood sampling.
The prothrombin index is a measure of the rate at which blood clotting is triggered along the intrinsic pathway. It is calculated on the basis of prothrombin time, therefore, its increase is observed with the same disorders in the body as an increase in PT, as well as a decrease.
To determine the PTI, the patient's plasma clotting time is divided by this value in the control sample. Normally, the result should be 95-105%.
The accuracy of the analysis for the prothrombin index depends on the sensitivity of the drugs used in the laboratory. Therefore, it cannot be called universal, in contrast to the Quick prothrombin test.
Increased prothrombin
If the Quick prothrombin test is elevated and shows high values (up to 150% or more), the reason for this may be:
- DIC syndrome;
- cholestasis and other diseases that reduce the activity of vitamin K;
- diseases that disrupt the functioning of fibrin;
- hereditary and acquired pathologies leading to a deficiency of coagulation factors (, liver disease, nephrotic syndrome).
Increased prothrombin also appears with long-term use drugs:
- antibiotics;
- diuretics;
- Aspirin;
- indirect anticoagulants;
- anabolic steroids;
- Methotrexate;
- laxatives;
- nicotinic acid;
- Heparin and other clotting inhibitors.
Prothrombin rate, table
Extreme PC values are below 78 and above 142%. The rates of prothrombin according to Quick are presented in the table.
| Age, years | PC / td norm limits> |
| until 6 | 80-100 |
| 6-12 | 79-102 |
| 12-18 | 78-110 |
| 18-25 | 82-115 |
| 25-45 | 78-135 |
| 45-65 | from 78 to 142 |
The rates of prothrombin in men and women are one age group do not differ. Normal values of prothrombin time for both sexes are 9-12 sec. The norm of prothrombin in the blood of women expecting a baby is slightly higher than normal values.
Low prothrombin
Low prothrombin according to Quick always speaks of excessively rapid formation of blood clots and is provoked by conditions such as:
- pregnancy and postpartum period;
- venous thrombosis;
- penetration of thromboplastin into blood vessels due to tissue damage;
- high blood viscosity (polycythemia).
The decrease in PC can be explained by such a dependence - the activity of the prothrombin protein is high, the blood clots faster compared to the control plasma sample, therefore the prothrombin test according to Quick is below normal.
Low prothrombin according to Quick can also be caused by taking Mercaptopurine, hormonal contraceptives and other drugs that increase blood density.
Prothrombin during pregnancy
Coagulogram is an obligatory part of the tests for pregnant women. Evaluation of this study, including prothrombin tests, makes it possible to timely identify conditions that are dangerous to the health of the child and the expectant mother.
Prothrombin according to Quick during pregnancy is normally slightly lowered, that is, the activity of the coagulation system increases. This is due to the emergence of a new circle of blood circulation and the preparation of the body for the upcoming childbirth and possible blood loss.
A very low PC can provoke the development of thrombosis, and its increase in pregnant women can cause heavy bleeding during childbirth, including internal.
Heavy bleeding can cause hemolytic shock due to mixing of the mother's and baby's blood. This is one of frequent reasons postpartum mortality. To avoid this, in this situation, not only monitor and control the state of the coagulation system, but also introduce immunoglobulins at the 28th week of pregnancy, which destroy potentially dangerous antibodies.
- The norm of the prothrombin index for women carrying a child is 80-100%. With him high values in order to avoid thrombosis and other complications, drugs are shown that reduce increased activity coagulability.
- Conversely, a low PI carries a risk of bleeding. Normal value prothrombin time for pregnant women - 11-18 sec. During pregnancy, any deviation from the norm in the coagulogram is a reason for thorough examination and in most cases, hospitalizations.
Prothrombin is a complex protein made in the liver. According to its quantity, a conclusion is made about the blood coagulation system. For the result of the analysis to be informative, blood on an empty stomach, preferably in the morning, between eight and eleven o'clock.
At least eight and no more than fourteen hours after last admission food. At this time, you can only drink water. The day before the analysis, you need to limit fried and fatty foods, do not take alcohol, it is necessary to exclude heavy physical activity. Within half an hour before the test, psychoemotional and physical stress should be excluded. It is impossible for half an hour before blood sampling.
Blood sampling must be carried out prior to administration. drugs and not earlier than one to two weeks after them. If their reception cannot be canceled, in the referral to the study, the doctor must indicate which drugs the patient is taking and in what doses.
High level fibrinogen is indicative of acute inflammatory processes and tissue death, it may be associated with increased risk hypertension, heart attack, stroke, diabetes and even cancer. Increased fibrinogen in the body causes inflammatory damage to the walls of the arteries, prepares the ground for atherosclerotic plaque and thrombus formation. A blood clot blocking one of the arteries in the brain can cause a stroke, and thrombosis coronary artery provokes the development of myocardial infarction.
Too low fibrinogen levels can cause profuse bleeding that are hard to stop. As a rule, it is as a result of donor blood loss due to drug use. A decrease in its concentration is also observed in congenital hypofibrinogenemia and afibrinogenemia, secondary disorders of the formation of fibrinogen in the liver, as well as in coagulopathies of various origins... For normal clot formation, the minimum required plasma fibrinogen level should be 0.5 g / L.
During pregnancy, the membranes of the embryo are formed. The cells of the membrane of the embryo, that is, the chorionic cells synthesize the hormone in the woman's blood - chorionic gonadotropin human (hCG). All studies for diagnosing pregnancy are based on the determination of this hormone.
You will need
- - referral of a gynecologist.
Instructions
To diagnose pregnancy, a blood test is performed for human chorionic gonadotropin (hCG or hCG).
A blood test for hCG is carried out in specialized laboratories in the direction of a doctor - gynecologist.
Human blood contains many components by which one can judge the state of the body. There is a complex laboratory research, showing the degree of norm or deviation of a particular indicator.
One of critical indicators requiring regular check-up in case of illness diabetes mellitus- blood clotting.
Blood clotting is an indicator responsible for regulating the degree of bleeding. If the blood vessels are damaged, the substances that make up the blood form blood clots, which prevent further blood loss. With normal clotting after 10 minutes. after minor damage to the vessel, a blood clot forms.
If the clot formation process begins much faster, then this may indicate increased coagulability blood - thrombophilia. Thrombophilia is a blood disease that leads to the formation of blood clots and clots in blood vessels and capillaries, leading to a lack of oxygen in human tissues and organs, causing heart attack, stroke, varicose veins, thrombosis and diseases of internal organs.
Substances that regulate the degree of blood clotting - prothrombin and fibrinogen.
Prothrombin
Prothrombin is an important plasma protein that indicates the degree of blood clotting. It affects the degree of blood clot formation and precedes thrombin, a protein that stimulates blood clot formation.
Prothrombin is produced by vitamin K in the liver. Using the prothrombin index, it is possible to assess the functioning of the liver and gastrointestinal tract.
When analyzing, the following indicators are obtained:
- Prothrombin time is an indicator characterizing the rate of blood clotting, in fact, indicating the degree of concentration of prothrombin in the blood. The result is indicated in seconds. Norm 9-13 sec;
- Prothrombin according to Quick is an indicator characterizing the activity of prothrombin, expressed as a percentage, established using a calibration graph built on the change in prothrombin time in normal plasma solutions. The rate, depending on the equipment used, is 77-120% .;
- Prothrombin index - is determined by the ratio of prothrombin time, characteristic of a healthy person to the time of a person with poor blood clotting. The norm is 80-110%;
- The INR index is an indicator used to assess the effectiveness of treatment with drugs aimed at preventing blood clots. Have healthy people the index is in the range of 80-115%.
Analysis procedure
Before starting blood sampling for analysis, the doctor should find out about the drugs taken by the diabetic. In the presence of drugs that can affect the result of the study, they are temporarily canceled.
No need to adhere to research special diets or follow a diet (except for the diet and regimen necessary for diabetes mellitus).
Puncture of blood is carried out from a vein in the arm, after which the injection site is pressed with a cotton ball until the bleeding stops. If a bruise forms at the puncture site, warming procedures are prescribed.
Deviations from the norm
An increased norm of prothrombin time (more than 13 seconds) indicates the possibility of thrombophilia development due to an excess of vitamin K (more about fat-soluble vitamins, which include vitamin K read in this article). People with diabetes mellitus have an overestimated average, so it is important to periodically analyze to determine the degree of deviation.
The value of the prothrombin time, deviated from the norm downward (less than 9 seconds), may be the result of a decrease in blood clotting, indicating a lack of vitamin K or poor absorption of the vitamin in the intestine as a result of dysbiosis and enterocolitis.
A number of factors can serve to obtain an incorrect test result for prothrombin:
- Alcohol abuse;
- Destruction of red blood cells due to careless handling of a test tube with material;
- Capillary blood collection.
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