Prothrombin index: normal for women and men, decreased, increased, what does this mean? Prothrombin index, norm and meaning Low prothrombin index what does it mean

PTI (prothrombin index) - what is it? At the time of the study, a blood test can determine how long it takes for a particular person’s plasma to clot and compare the value with established standards. The ratio of this difference is converted into percentages. The permissible norm in the blood is 78–142%, the prothrombin index according to Quick is 95–105%.

Prothrombin is a protein that is a precursor of thrombin. And thrombin, in turn, plays an important role in thrombus formation. Prothrombin is produced in the liver. Vitamin K contributes to this. If there is not enough vitamin K, bleeding can be caused due to a decrease in the amount of prothrombin.

When is the analysis done?

Coagulation analysis is necessary in the following cases:

• on the eve of surgery;
• for patients who use anticoagulants to prevent blood clots;
• during pregnancy;
• patients with blood clotting problems, suffering from varicose veins;
• in people suffering from disorders of the cardiovascular system;
• with vitamin K deficiency;
• with cirrhosis of the liver.

The following specialists can prescribe such an analysis:

• traumatologist;
• therapist;
• pediatrician;
• cardiologist;
• surgeon;
• pulmonologist

How to get tested

Before you go to a medical facility for testing, you need to prepare.

• To obtain the most accurate result, it is better to take the test on an empty stomach between 8 and 11 am. Ideally, the interval between the last meal and the test should be from 8 to 14 hours. Please note: this time should not exceed 14 hours.
• The day before, you should not eat fatty or spicy foods, and you should avoid drinking alcoholic beverages. One hour before the test you should not smoke.
• Contraindications relate to taking medications. If you are taking a course of certain medications, you should postpone the test until you stop treatment. There are situations when taking medications cannot be interrupted. In such cases, the patient is obliged to provide all information about the dosage and names of the drugs.

Blood for analysis is taken from a vein. It is collected in a test tube with sodium citrate. The plasma is then separated from the blood cells using a centrifuge.

Decoding the results

Reasons for the low rate:

The percentage has increased due to:

• Congenital clotting problems.
• Vitamin K deficiency.
• Heparin.
• Oncological diseases.
• Use of broad spectrum antibiotics.

Normal for pregnant women

The prothrombin index during pregnancy increases to 90–120%. This can be attributed to hormonal changes in the body of a pregnant woman.

It is important to carry out PTI analysis two to four times, especially during pregnancy. Great emphasis should be placed on it in the last trimester, because there is very little time left before birth and it is necessary to monitor the dynamics.

When the percentage rises to 150, there is a risk of placental abruption. When the rate drops below 90%, you can expect heavy bleeding during or after childbirth.

If a pregnant woman exhibits irregularities in the percentage indicator, you should not refuse inpatient monitoring at the maternity hospital. It is important for the expectant mother to be under the supervision of specialists.

Kwik indicators

Quick analysis is done for additional examination of the gastrointestinal tract, as well as the liver.

Quick analysis is performed in the following cases:

1. When clotting is impaired.
2. There are ailments associated with the liver.
3. There is a process of increased thrombus formation.
4. With a disease such as blood cancer.
5. In cases associated with vitamin K deficiency.

What limits of indicators are acceptable:

• Up to 6 years - 80–100.
• From 6 to 12 - 79–102.
• From 12 to 18 - 78–110.
• From 18 to 25 - 82–115.
• From 25 to 45 - 78–135.
• From 45 to 65 - 78–142.

The norm for women and the norm for men, regardless of age, are identical.

Prothrombin time is an indicator that reflects the seconds during which plasma coagulates after adding the desired mixture to it.

• In children, especially newborns, this figure is 14–18 seconds.
• For adults, the normal figure is 10–15. The optimal value of prothrombin time ranges from 9–12 seconds.

INR - international normalized ratio

INR is a special method that is used to control the final result of the prothrombin test. The use of this method is strongly recommended by representatives of international health organizations.

Thanks to the results that the specialist receives after this study, he can monitor how effectively the treatment with synthetic drugs is being carried out.

• The INR norm is 0.85–1.15.
• If we are talking about the treatment or prevention of venous thrombosis, pulmonary diseases or deformation of the heart valves, then the INR norm can reach 3.0.

Prothrombin is increased

If prothrombin according to Quick is elevated, what could cause this result and what measures should be taken? An increase is indicated by a prothrombin indicator of more than 150%.

The following factors can lead to this:

1. Many diseases characterized by a decrease in vitamin K.
2. DIC syndrome.
3. Diseases that interfere with the normal production of fibrin.
4. Heredity and other pathologies that can lead to clotting problems.
5. An increase in the indicator can be caused by medications when used for a long time, for example:
   1. Aspirin.
   2. Broad-spectrum antibiotics.
   3. Heparin.
   4. Anabolic.
   5. Laxatives.
   6. Methotrexate.
   7. Nicotinic acid.

Most often, prothrombin in the female and male population increases at the age of 45–50 years. This indicator may be increased in women due to taking hormonal drugs.

If a woman is diagnosed with a serious cardiovascular disease, the use of hormonal contraceptive pills should be immediately discontinued. You can replace them with an analogue in the form of suppositories or a vaginal ring.

What to do with an increased prothrombin level

How to reduce prothrombin level? This category of people must adhere to a certain diet and lifestyle.

You need to eat as many foods as possible that help thin the blood. It is important to understand that there are a number of foods that can cause blood to thicken.

List of necessary ingredients to lower prothrombin levels:

• Everyone knows oatmeal. Oatmeal not only helps stabilize digestion, but also prevents blood thickening. Ideally, you should consume this dish as breakfast. If desired, you can supplement the porridge with fresh berries.
• Tomato juice, especially when made from fresh vegetables yourself. Many people make the grave mistake of adding salt to juice.
• Beetroot is an ideal vegetable that helps reduce prothrombin levels.
• What is a diet without ginger? It can be added to tea. Ginger root thins the blood and prevents the formation of blood clots.
• Flaxseed oil, olive oil.
• Fish fat. Currently, it can be purchased in pharmacies in capsule form. This is an excellent option without odor or taste.
• It is recommended to use apple cider vinegar during cooking.
• A pineapple. It is enough to eat just a little to trigger beneficial processes in the body.

What rules should you follow during the diet:

1. Give preference to vegetables, fruits and fresh berries.
2. Meat may be present on the table, but in minimal doses.
3. Meat can be replaced with fish.
4. Limit your consumption of baked goods.
5. It is best to cook in a double boiler.
6. You need to eat more often, but in doses.
7. Be sure to drink regularly.

What not to eat or drink:

Reduced prothrombin

If the prothrombin index is low, this may indicate excessive activity of the prothrombin protein. A decrease may be observed in pregnant women, those suffering from polycythemia (this is increased blood viscosity), and patients with venous thrombosis.

A decrease in the indicator may indicate the following diseases:

• Gastrointestinal diseases.
• Dysbacteriosis.
• Prothrombin deficiency.
• Hypovitaminosis.
• Oncological diseases.
• Allergic reaction.

Most often, a decrease in this indicator occurs due to diet and occurs among representatives of the stronger half of humanity. It is men who make the choice in favor of meat products, consuming few vegetables and fruits.

What to do if the prothrombin level is low?

Typically, specialists prescribe their patients the use of medications such as heparin and warfarin.

In conjunction with drug treatment, you need to monitor your diet. Here is a list of foods that are not recommended for consumption if prothrombin levels are low:

• Animal fats.
• Buckwheat porridge.
• Beets, red cabbage, red pepper.
• Bakery products.
• Pickling and smoking.
• Greenery.
• Legumes.

Failures in prothrombin levels can lead to bleeding. They can be prevented if you include the right foods in your diet as preventive measures:

• Fish and fish oil.
• Onion and garlic.
• Citrus fruits, especially lemon.
• Ginger root.
• Green tea and cocoa.
• Oatmeal.
• Cranberries, raspberries or figs.

Fibrinogen

The protein fibrinogen is produced by the liver. It is he who takes part in thrombus formation. Analysis for the prothrombin index and fibrinogen protein characterizes the links of one chain.

When thrombin is activated, it entails a change in fibrinogen. And it, in turn, is converted into fibers - fibrin. These unbreakable fibers appear in the form of a blood clot, which already plays a direct role in blocking the vessel.

The fibrinogen protein reaches its peak in the first few days after a stroke, heart attack, inflammatory processes and influenza. An increase in this indicator can be observed in smokers, pregnant women, people suffering from diseases of the endocrine system, and with prolonged use of hormonal medications.

A decrease in fibrinogen protein is observed in people:

• with liver and gastrointestinal diseases;
• with a lack of vitamin B12;
• during pregnancy, toxicosis;
• during the period of taking anabolic steroids;
• when taking a certain group of medications.

The only effective prevention of any disease is giving up bad habits, proper nutrition, dosed physical activity and timely examination.

Prothrombin: normal

In the human body, there is a constant movement of blood - a life-giving fluid that provides nutrition to all cells of the body and metabolism. The length of the vessels is thousands of kilometers, and their area is more than half a hectare. It is impossible to imagine how all this fits in the body of an adult.

But the amount of life-giving fluid is small: for men - a little more than five liters, and for women - about four. Therefore, when injuries or cuts disrupt the integrity of the circulatory system, its contents can quickly spill out, threatening a person with death.

If blood loss is not prevented, the main transport link that nourishes the entire body will cease to exist.

To prevent this from happening, nature has created a system responsible for blood clotting. It is this that is capable of triggering protective mechanisms that close the wound and prevent blood from leaving the vessels.

The value of prothrombin in the body

Part of this system are special plasma proteins called blood clotting factors. They are designated by Roman numerals from I to XIII. Prothrombin is one of the main components. This protein is blood clotting factor II.

The name “prothrombin” suggests that it is a precursor to thrombin, an active enzyme. With its assistance, a clot (thrombus) is formed, closing the wound and stopping blood loss.

A normal level of prothrombin indicates that the blood clotting process is working effectively and the body will be able to stop the loss of this life-giving fluid in time.

Protein testing is not performed as often as clinical blood testing. This procedure is not easy and is prescribed only in cases of extreme necessity, for example in case of blood diseases or problems with blood clotting.

Determination of prothrombin level is the most important test as part of a hemostasiogram.

Norm of prothrombin

Prothrombin molecules disintegrate very easily and quickly. It is difficult to separate them from other proteins, which makes determining its level much more difficult. Several methods are used for qualitative analysis.

• Prothrombin according to Quick. Today this method is generally accepted and widespread. This technique involves calculating the level of a substance as a percentage of the permissible amount. The following values ​​(%) are considered optimal:
  • minimum – 70;
  • maximum – 120.

  The indicator allows you to determine the activity of the thrombosed plasma complex in comparison with various dilutions of the patient’s plasma. A graph of changes in prothrombin is drawn up, which is based on data on blood clotting time.

  Experts consider the Quick analysis to be the most accurate when low prothrombin levels are recorded.

• Prothrombin index is also determined as a percentage. The normal indicator is within the following limits (%):
  • minimum – 95;
  • maximum – 105.

  The results of the two tests above may be the same if prothrombin is normal. But when its value is lower than optimal, they diverge significantly. The index is highly dependent on the sensitivity of the chemical reagents used in testing.

• Prothrombin time - shows how many seconds it takes the plasma to clot after adding a special mixture to it.

  The final test data depends on age. In newborn babies, blood clotting time can range from 14 to 18 seconds. And these indicators are normal. In adults, a period of 10 to 15 seconds is considered optimal.

• International normalized ratio - INR. This method is additional and is used to monitor the results of the prothrombin test.

  The INR method is recommended by WHO experts and other international organizations and committees that study thrombosis and standardize in hematology. The results of such a test allow the doctor to monitor the effectiveness of treatment with anticoagulants - synthetic substances that reduce the level of prothrombin in the blood and slow down its clotting. These drugs are used in the treatment of thrombophlebitis, thrombosis, that is, diseases that form dangerous blood clots in the venous vessels.

  The normal INR is 0.85–1.15.

  When treating diseases such as pulmonary embolism, venous thrombosis, or pathologies of the heart valves, the permissible limits increase to 3.0.

Indications for prothrombin test

A blood test for prothrombin may be prescribed by a doctor in the following cases:

• the patient has bleeding that does not stop for too long (this clearly indicates that blood clotting is below normal levels);
• the performance of liver enzymes and the liver in general decreases;
• to monitor coagulation during long-term use of anticoagulants;
• for antiphospholipid syndrome in order to clarify the cause of the disease;
• if there are diseases that are accompanied by a lack of vitamin K in the body.

Some indirect reasons requiring a prothrombin test are purely individual in nature. Most often, the study is prescribed to representatives of the fair sex between the ages of 50 and 60. It is at this time that hormonal changes occur, causing changes in the composition and structure of the blood.

The following doctors can prescribe an analysis:

Blood from a vein is used for the study. In order for the results to be as correct as possible, before the study you must follow the standard rules:

• dinner no later than eight o'clock in the evening, at least 12 hours before testing;
• Before the study, be sure to get your nerves in order and not overexert yourself physically;
• Do not smoke on the day of the test and do not drink strong drinks.

As usual, blood is donated in the morning on an empty stomach. It is necessary to inform medical personnel about all medications taken in the last 24 hours.

Prothrombin is increased

An increased level of prothrombin in the blood indicates that blood clotting is greater than normal. This means that it becomes too viscous, which impedes blood circulation and leads to blockage of blood vessels.

The following ailments can provoke an increase in prothrombin levels, and therefore blood clotting:

• malignant neoplasms;
• liver pathologies;
• thromboembolism;
• polycythemia;
• progressive angina.

An increase in the amount of protein can also be caused by the following factors:

• an excess of vitamin K in the body, with the help of which prothrombin is produced;
• use of anticoagulants, antibiotics, nicotinic acid, and hormonal contraceptives in therapy. Excessive use of aspirin, anabolic steroids, and laxatives can also affect the increase in prothrombin.

Quite often, the protein content increases during pregnancy. Most often it appears in the last trimester and does not require treatment.

Prothrombin is reduced: reasons

A reduced level of prothrombin is dangerous because even a minor injury that damages a blood vessel can result in significant blood loss. After all, the formation of a blood clot occurs more slowly than it should.

A decrease in prothrombin levels is provoked by the following reasons:

• Certain liver pathologies, although most of them are accompanied by an increase in protein. The prothrombin content decreases in acute and chronic forms of hepatitis. Liver cirrhosis has a similar effect.
• Insufficient synthesis of vitamin K by the body. This process develops most often due to gastrointestinal ailments and dysbiosis.
• Deficiency of fibrinogen, a protein that is produced in the liver and then converted into fibrin, which is the basis of the clot during blood clotting. Such a deficiency can be either congenital or acquired.
• Taking medications for medicinal purposes that promote blood clotting.

It is possible to bring the prothrombin level back to normal, but anything should be done only after consulting a specialist.

Therapy is aimed at eliminating the ailments that caused the problem. Quite often, the basis of treatment is a special diet.

What does it mean if the prothrombin index is elevated?

If the prothrombin index is elevated, then this condition can be dangerous to life and health. This is due to the fact that this indicator is responsible for blood clotting and the formation of blood clots. Accordingly, the higher the indicator, the greater the likelihood of pathological processes developing in the patient’s body. Most often, in addition to problems with blood clotting, disturbances in the functioning of the gastrointestinal tract (gastrointestinal tract) and liver are observed. Any deviations from the norm of this indicator are cause for concern.

When is a laboratory test and normal limits prescribed?

A high prothrombin index can be detected through a laboratory test, which is prescribed to patients during a preventive examination or when complaining of poor health.

During the study, the ratio of the prothrombin time in a particular patient to the time standard of the control serum is studied. The study allows you to determine the activity of blood clotting, as well as the time of clot formation.

Only a specialist should decipher the results of a laboratory test, based on standards that differ for men and women. For representatives of the stronger half, a higher upper limit of the indicator is considered normal.

All normal limits are determined as a percentage and amount to 95-105%. In addition, when decrypting, the following is taken into account:

1. Patient's age.
2. Gender.
3. Conditions for analysis.
4. Reagent sensitivity.

Depending on these factors, the percentage of the indicator can be 72-142%. That is why it is so important that a qualified specialist does the decoding.

The need for this study is especially acute before surgery to assess the risk of bleeding. For the purpose of prevention, monitoring the prothrombin index is necessary for patients in the older age group, especially men over 40 years of age.

In addition, you should definitely go through this procedure:

• women planning pregnancy;
• patients taking Warfarin;
• women with heavy monthly bleeding;
• patients with hereditary blood clotting diseases.

Why is the rate rising?

If the index is elevated, then the human body has problems with the hemostasis system. Most often, an increase is observed in the following cases:

• DIC (disseminated intravascular coagulation);
• cholestasis;
• vitamin K deficiency;
• some diseases;
• hereditary factor.

In addition, a number of medications that have been taken for quite a long time can provoke this phenomenon if the dosage is not followed.

Such drugs include:

And also most often, increased levels are observed in patients with gastrointestinal diseases. This is due to the fact that during various pathological processes occurring in the gastrointestinal tract, its direct function, which is the absorption of nutrients into the body, decreases. Due to their lack, the functioning of the entire body is disrupted, which leads to various negative changes. An increase in the index is observed during surgical intervention in the gastrointestinal tract.

In some cases, an increased index is observed in people with a hereditary factor. Such patients require genetic analysis for an accurate diagnosis.

Conducting research during pregnancy

For pregnant women, donating blood to determine the prothrombin index is necessary, since an elevated level may indicate a danger of pregnancy and delivery.

Accurate indicators help to avoid the formation of blood clots during the entire period of gestation and in the postpartum recovery period. If the index is elevated, then expectant mothers are prescribed drugs that prevent increased blood clotting and prevent the formation of blood clots.

An increased index is of great danger during pregnancy, as it can lead to the formation of placental blood clots.

They are capable of clogging blood vessels, which leads to:

• to circulatory disorders;
• to blockage of blood vessels;
• to placental infarction;
• to intrauterine growth retardation.

In addition, an increased rate may indicate health problems in the expectant mother.

Among the particularly dangerous diseases are:

If the indicator exceeds the normal limits, then this condition requires careful monitoring by doctors. In some cases, hospitalization may be required.

When should you refuse the procedure?

In some cases, when the results of a laboratory test may be false, the procedure should be abandoned.

Such cases include:

• taking special medications that affect the absorption of vitamin K in the body;
• intoxication of the body, accompanied by diarrhea and vomiting, can cause a temporary increase in the prothrombin index;
• high consumption of foods high in vitamin K;
• drinking large amounts of alcohol before blood sampling and several days before the scheduled event;
• taking laxatives;
• treatment with homeopathy.

When you receive test results where this indicator is higher than normal, you must start taking medications to normalize blood clotting.

As a preventative measure (especially for those at risk), you should:

1. Maintain an optimal drinking regimen.
2. Eat plenty of fruits and vegetables.
3. Limit the use of herbal remedies that contain herbs that thicken the blood.

Prothrombin index: norm and deviations

Blood is constantly moving in the body of every person. The vessels have a total length of thousands of kilometers, and a large total area of ​​the inner wall.

Men have more than five liters of blood in their bodies, while women have slightly less. Any serious injury or cut can cause bleeding, and if not treated promptly, the person may die from loss of blood.

To prevent this from happening, nature has created a special system under the influence of which the blood coagulates. All possible protective mechanisms are launched, the wound will close, and blood will no longer escape from the vessels.

Prothrombin index - what is it?

Prothrombin is a protein compound necessary for complete blood clotting. It is produced in the liver. A prothrombin test is needed to assess blood clotting. The most common and universal method for this is Quick prothrombin.

The test reveals the activity of prothrombin in the blood in comparison with certain indicators. This is the ratio of the time at which plasma clotting occurs relative to the same process in the sample.

It is worth noting that the Quick prothrombin test is performed not only to assess blood clotting, but also to understand whether the liver and gastrointestinal tract are functioning properly.

Prothrombin according to Quick indications for analysis

We have looked at what prothrombin according to Quick is, but when should this analysis be carried out? There are certain indications:

A blood test for prothrombin is performed if there is a blood clotting disorder.

Due to autoimmune causes, thrombus formation is increased.

hemoblastosis, or blood cancer;

Pathology leading to disruption of vitamin K production.

Women in menopause.

Prothrombin time - what is it?

Depending on what caused the bleeding, blood can clot in several ways - internal or external. In the first case, this is due to the fact that the vessels are damaged from the outside. This can happen due to abrasions, bites or bruises. In the second case, the integrity of the walls of blood vessels from the inside occurs. This is caused by toxins, antibodies, and various pathogenic microorganisms.

Prothrombin time is an indicator by which you can understand how the internal pathway works in the hemocoagulation system.

Prothrombin time increases as a result of the following factors:

The body lacks vitamin K.

Taking certain medications.

The bile ducts are blocked or inflamed.

Absorption of fats in the intestines is impaired.

The more prothrombin in the blood is lowered, the higher the prothrombin time will be, because in this state the clotting process will be slowed down.

Prothrombin-lowering factors can be:

A decrease in petit occurs in women who are carrying a baby.

There is a deviation from the norm of hematocrit.

Prothrombin time may show a low result if the blood was taken incorrectly or the plasma was stored for a very long time before the study.

What is prothrombin index?

PTI in the blood is an indicator that reflects the speed at which blood coagulation starts along its internal pathway. It is calculated based on prothrombin time. A low prothrombin index is associated with the same factors as a decrease in PT.

The normal prothrombin index for women is approximately 95%. The normal prothrombin index in men is slightly higher and is about 105%. The accuracy of the analysis depends on many factors, for example, the drugs used in the laboratory.

Why is prothrombin high?

If prothrombin according to Quick is increased and its value is 150% or more, then there may be many reasons for this:

Diseases in which the activity of vitamin K decreases several times.

A syndrome called DIC.

Various pathologies acquired during life or hereditary, for example, amyloidosis, nephrotic syndrome, etc.

Increased prothrombin may also occur if you have taken the following medications for a long time:

Antibiotics or anabolics.

Inhibitors or heparin.

Norm of prothrombin in blood

Below is a table showing the petit rate:

Women and men at the same age have the same prothrombin level. If a woman is carrying a baby, then the level is slightly higher than normal, but there is nothing wrong with that, after the birth of the child everything will return to normal.

Why is prothrombin low?

A decrease in the prothrombin index according to Quick always indicates that blood clots form very quickly; many factors can lead to this:

A woman is pregnant or has recently given birth to a baby. These are normal indicators, after the woman’s body returns to normal, the level of petit will return to normal.

Blood viscosity is increased.

Some medications can also provoke a decrease in prothrombin.

Prothrombin in pregnant women

Every pregnant woman should undergo a test such as a coagulogram. Assessment of the condition plus prothrombin tests can identify any dangerous conditions for both the expectant mother and her child.

Prothrombin according to Quick (PC) in pregnant women is always slightly lower and this is the norm. The thing is that a new circle of blood circulation appears and the woman’s body is preparing for the fact that during childbirth it will have to lose a little blood.

A PC that is several times lower than normal can lead to thrombosis, and in pregnant women, its increase will lead to severe bleeding at the time of childbirth, and it is possible that it will be not only external, but also internal.

Bleeding due to incompatibility of the Rh factor of the child and the woman will lead to hemolytic complications.

In order to avoid this, women are under the full control of the attending physician, and from the 28th week they are injected with immunoglobulin (anti-Rhesus serum), under the influence of which dangerous antibodies will be destroyed. PI indicators for pregnant women are as follows:

In pregnant women, the prothrombin index should be within the % range. For high levels, certain medications are given.

With a low PI level, the risk of bleeding is high. The normal prothrombin time is approximately 18 seconds.

Under no circumstances should you try to increase or decrease your readings on your own; you should consult a doctor.

How to prepare for the test?

In order to get reliable results, it is necessary to donate blood for tests correctly. Blood is taken before 11 a.m., always on an empty stomach. In order to prepare for the analysis, you need to follow some recommendations:

About three days before you plan to go to the hospital, avoid fatty and fried foods. There is no talk of any alcoholic drinks. All this will be a big burden on the liver.

Three hours before donating blood, you should not smoke, as nicotine will lead to a decrease in the prothrombin index.

If you regularly take any medications, stop taking them six hours before you plan to donate blood, after which you can resume taking them.

On this day, or rather before the test, you cannot engage in heavy physical activity.

It is impossible to take blood samples from women during menstruation; at this moment the indicators will be unreliable.

Blood is taken from a vein, after which it is placed in a special tube with saline solution, centrifuged, and then a thorough examination will take place.

Prothrombin is increased: what to do?

If the prothrombin index is elevated, it certainly needs to be reduced. People in this category must adhere to a special diet; they must eat only those foods that will thin the blood. But you need to understand that there are many foods that lead to blood thickening.

So, to normalize prothrombin levels, you need to eat the following foods:

Oatmeal. It not only helps digestion stabilize, but also prevents the blood from becoming thick. It is better to eat this dish in the morning at breakfast.

Tomato juice made from fresh vegetables. Many people at this moment make the most serious mistake - adding salt, but this should never be done.

Beets are the best vegetable with which you can reduce prothrombin.

It is simply impossible to imagine a diet without ginger! It is added to tea, or any other dish. This will thin the blood and is also a good way to prevent the formation of thrombosis.

Fish fat. You can buy it at any pharmacy; this is the best option for thinning the blood.

During the diet, you must follow some rules, which include the following:

Your diet should include fresh berries and fruits.

You shouldn’t give up meat completely, but you don’t need to get carried away with it either.

It is better to refuse baking.

Drink at least two liters of water per day.

Eat as often as possible, but in small portions.

There should not be any alcohol, it does not have the best effect on the condition of the entire body as a whole.

Reduced prothrombin what to do?

In addition to treatment with medications, you also need to monitor your diet. The following products are not recommended:

Bread and animal fats.

Smoked and salted.

Greens and legumes are also contraindicated.

Reduced prothrombin can lead to bleeding. Of course, this can be prevented; to do this, you need to include the following products:

Eat more onions and garlic.

Citrus fruits are especially useful.

Figs, raspberries and cranberries.

In order not to encounter such unpleasant problems in your life, you need to constantly monitor your health. First of all, this concerns a healthy lifestyle, no alcohol, smoking, etc. If any disease occurs, treatment must be carried out in a timely manner, this will avoid further complications.

If prothrombin according to Quick is increased, what does this mean for an adult?

Prothrombin is a proenzyme synthesized in the liver under the influence of vitamin K. This glycoprotein is one of the main indicators of a hemostasiogram (clotting test). Being a precursor of thrombin (a protein that stimulates the process of thrombosis), prothrombin in a blood test reflects the state of the entire coagulation system. Prothrombin is also called the second factor of hemostasis.

Monitoring prothrombin values ​​allows you to assess the risk of developing hypercoagulation or bleeding, as well as diagnose some pathologies of the liver and gastrointestinal tract.

The initiation of thrombus formation in response to a violation of the integrity of the vascular wall occurs along the external coagulation pathway. The internal pathway of hemostasis is responsible for the formation of a blood clot in areas with slow blood flow or an abnormally changed vascular wall.

For a comprehensive study of hemostasis, the study is most often used:

• prothrombin time (PT);
• activated partial thromboplastin time;
• platelet count;
• quantitative determination of fibrinogen.

What does “according to Kwik” mean?

Armand Quick developed three different tests in the course of his research, but of interest to us is his one-step test for the amount of prothrombin present in the blood plasma and the determination of the clotting time of prothrombin.

It was this test that made it possible to widely use the expression “according to Quick.” We must pay tribute that it is the Armand Quick test that gives the most accurate picture of the ability of blood to clot.

What is prothrombin according to Quick

To study the level of prothrombin in the blood, the following are used: prothrombin according to Quick and the international normalized ratio. These indicators reflect prothrombin time, which characterizes prothrombin and thrombin formation, that is, the 1st and 2nd phases of plasma hemostasis.

Prothrombin time according to Quick is a method for assessing deficient states of the prothrombin complex and displaying the activity of the external mechanism of hemostasis. The result of the analysis is displayed as a percentage of prothrombin activity, determined according to a special graph built using dilution of standard plasma. When constructing the graph, prothrombin time is taken into account, that is, the time of plasma hemostasis recorded in seconds after administration of the thromboplastin-Ca mixture.

Also, when studying hemostasis, the prothrombin index according to Quick can be assessed. The prothrombin index (PTI) is the ratio of normal PT (values ​​in healthy people) to the patient's PT. Analysis responses are recorded as percentages.

Prothrombin according to Quick and PTI make it possible to accurately reflect the degree of prothrombin activity in a patient compared to PT in control plasma (values ​​in healthy people). This calculation method makes it possible to obtain reliable results even in areas of low values, since, unlike PTI and PT, it does not depend on the sensitivity of laboratory reagents to minimum prothrombin values. This allows you to significantly reduce the likelihood of diagnostic errors.

In healthy people, prothrombin according to Quick and PTI may be the same. With low prothrombin (most often observed in patients receiving treatment with NAs (indirect anticoagulants)), these indicators may diverge.

As an additional way of expressing the prothrombin test, INR is used. This is an international normalized ratio used to evaluate the quality and effectiveness of AN treatment.

This indicator is calculated using a special formula:

International normalized ratio = (patient PT / normal normal PT) * international sensitivity index value.

Sensitivity index - reflects the degree of sensitivity of thromboplastin.

The international normalized ratio values ​​that need to be achieved by treating a patient with NA drugs will depend on the purpose of therapy and are set by the doctor, in accordance with the patient’s diagnosis.

When interpreting the results, it should be taken into account that the results of prothrombin according to Quick and the international standardized ratio will be inverse

dependencies. That is, reduced prothrombin according to Quick will be accompanied by an increase in INR.

The importance of the prothrombin complex and its significance in the body

The result of prothrombin time depends on the following hemostasis factors:

• the second – prothrombin (proferent);
• fifth – labile factor (protein cofactor);
• seventh - proconvertin (proenzyme);
• tenth – Stewart factor (proenzyme).

These factors make up the so-called prothrombin complex. Prothrombin time (PT) will also depend on the liver’s ability to synthesize protein. Since prothrombin complex factors are synthesized in the liver, this analysis can be used in diagnosing its pathologies.

It should also be noted that the synthesis of the prothrombin complex occurs only in the presence of vitamin K. Due to the fact that indirect anticoagulants antagonize vitamin K, the prothrombin test can be effectively used to monitor AN therapy.

Indications for the test

• various pathologies of the coagulation system;
• conducting screenings assessing the hemostatic system;
• monitoring coagulation during long-term treatment with NA drugs;
• diagnosis of liver pathologies accompanied by a violation of its protein-synthesizing function;
• comprehensive examination of patients before operations.

Studying the state of the hemostatic system is necessary for patients with:

• severe bleeding gums, nosebleeds, heavy menstrual bleeding, prolonged bleeding after cuts and wounds, chronic anemia, easily formed hematomas, hemorrhages in muscles and joints;
• miscarriage, repeated miscarriages;
• loss of vision of unknown origin;
• hereditary pathologies of the blood coagulation system;
• liver diseases;
• thrombosis;
• suspected DIC and PE (pulmonary embolism);
• pathologies of the cardiovascular system.

A study of prothrombin levels during pregnancy is mandatory. This test allows you to assess the risk and prevent bleeding during childbirth and placental abruption (with reduced prothrombin), as well as thrombosis (with increased values).

How to take a prothrombin test

Venous blood is used for diagnosis. The material should be collected on an empty stomach. Eating is excluded at least twelve hours before the test. An hour before the test, you must avoid smoking, stress and physical activity. The consumption of juices, coffee, sweet tea and carbonated drinks is prohibited. Water intake does not affect the analysis results. Alcoholic drinks must be avoided a week before sampling.

A separate category of patients consists of persons undergoing treatment for AN. To study prothrombin in this category of patients, the regimen of using vitamin K antagonists (warfarin) should be strictly followed. If the doctor has not established an individual dosage regimen, then on the day before diagnosis the daily dose of the drug is taken once from four to five o’clock in the evening.

Prothrombin. Norm and interpretation of tests

Prothrombin according to Quick, the norm is from 70 to 120% or from 78 to 142%, depending on the laboratory. In this regard, you should focus on the norm indicators indicated on the results form.

The norm for pregnant women also corresponds to values ​​from 70 to 120% or from 78 to 142%. A slight increase in values ​​may be observed in the last months of pregnancy.

International normalized ratio values ​​in adults range from 0.8 to 1.2. For patients receiving treatment with indirect anticoagulant drugs, the values ​​may shift from 2.0 to 3.0. In people with prosthetic valves, the INR ranges from 2.5 to 3.5.

For babies under three days of age, the international normalized ratio is from 1.15 to 1.35.

From three days to a month – from 1.05 to 1.35.

From a month to a year of life - from 0.86 to 1.22.

From one to six years – from 0.92 to 1.14.

From six to eleven years – from 0.86 to 1.2.

From eleven to sixteen years – from 0.97 to 1.3.

From the age of sixteen, the INR norm does not differ from adults.

From the first to the thirteenth week – from 0.8 to 1.2.

From thirteenth to twenty-first – from 0.56 to 1.1.

From the 21st to the twenty-ninth – from 0.5 to 1.13.

From 29th to thirty-fifth - from 0.58 to 1.17.

From 35th – from 0.15 to 1.14.

Values ​​are recorded in seconds.

For babies up to three days old, the PV norm is from 14.4 to 16.4.

From three days to a month – from 13.5 to 16.4.

From a month to a year of life - from 11.5 to 15.3.

From one to six years – from 12.1 to 14.5.

From six to eleven years - from 11.7 to 15.1.

From eleven to sixteen years old - from 12.7 to 16.1.

Reasons for increased or decreased prothrombin

• increased susceptibility to thrombosis;
• hypercoagulable stage of DIC syndrome;
• initial stages of deep vein thrombosis;
• pregnancy (possible increase in values ​​in recent months);
• increased activity of the seventh hemostasis factor;
• polycythemia;
• thromboembolism;
• oncological tumors and their active metastasis;
• thromboembolism;
• threat of acute myocardial infarction;
• hyperglobulinemia;
• thickening of the blood as a result of severe dehydration.

An increase in prothrombin according to Quick is correspondingly accompanied by a decrease in the international normalized ratio. This picture in the analyzes indicates a high risk of blood clots.

Prothrombin according to Quick is reduced (and the international normalized indicator is increased) with:

• deficits of the first, second, fifth, seventh and tenth hemostasis factors;
• hypofibrinogenemia;
• dysfibrinogenemia;
• vitamin K deficiency;
• conditions of newborns caused by maternal vitamin K deficiency during pregnancy (hemorrhagic diathesis of newborns);
• amyloidosis;
• hypocoagulation phase of DIC syndrome;
• adenoma or cancerous lesion of the pancreas (pancreas);
• nephrotic syndrome:
• malabsorption type celiac disease;
• acute leukemia;
• antiphospholipid syndrome;
• congestive heart failure (heart failure);
• infectious-toxic shock;
• severe liver pathologies (including those caused by alcohol);
• obstructive jaundice.

A decrease in prothrombin according to Quick and an increase in INR is characteristic of increased bleeding and pathologies caused by deficiencies of blood coagulation factors.

When carrying out the analysis, it is necessary to take into account that prothrombin according to Quick decreases when:

• alcohol abuse,
• taking nalidixic acid,
• neomycin,
• streptomycin,
• sulfonamides,
• tetracyclines,
• streptomycin,
• chloramphenicol,
• levothyroxine,
• warfarin,
• heparin,
• diuretics,
• high doses of vitamin A,
• acetylsalicylic acid in high doses.

An increase in Quick values ​​can result from:

• long-term intake of vitamin K in high doses, or its excess intake from food (greens, pork liver, etc.),
• constant intake of antihistamines, vitamin C, caffeine,
• taking estrogen-containing oral contraceptives,
• treatment with corticosteroids, barbiturates, rifampicin, phenobarbital.

Prothrombin, prothrombin index and time: blood standards, interpretation of tests

As a rule, upon admission to inpatient treatment, each patient the next morning before breakfast undergoes mandatory finger tests (complete blood count, sugar and prothrombin). These laboratory tests are considered the main indicative studies, since they are the ones who “paint” the overall picture of the patient’s condition. Other (biochemical, including coagulation) tests can be prescribed on the day of admission, if the problem in the patient’s body is clearly defined, or if, in the process of examination and treatment, the goal is to thoroughly study the functional abilities of the patient’s organs and systems and monitor the effectiveness of therapy .

The unique medium moving through blood vessels is classified according to its characteristics as connective tissue. Being in a liquid state and possessing fluidity, which prevents the adhesion of formed elements, blood, at the same time, is able to quickly clot when the vascular wall is damaged. She has this opportunity thanks to the blood coagulation system and its factor, one of which is prothrombin. It should be noted that all factors without violating the integrity of the vascular walls are in an inactive state. Activation of factors and the formation of blood clots inside the circulatory system without any reason threatens with serious complications for the body.

What is prothrombin?

stages of blood clotting

Prothrombin or factor II (FII) of the prothrombin complex is a protein (glycoprotein), a plasma factor of the coagulation system, which belongs to alpha2-globulins and is synthesized by hepatocytes (liver cells). It is important to note that the production of prothrombin will become noticeably more difficult if the amount of vitamin K in the body, which is so needed for the synthesis of this factor, decreases for some reason. If everything is normal in the body, then prothrombin does not show any activity, remaining as a precursor of thrombin - an enzyme that causes the polymerization of fibrinogen and the formation of a clot (thrombus), if the need arises.

In the circulating blood, plasma factors, being in the form of an inactive form of profactor (prothrombin → thrombin), always remain in relatively constant concentrations; activation occurs under the influence of coagulation factor XII (internal hemostatic system) and when blood comes into contact with damaged tissues (external hemostasis system).

The normal level of prothrombin in the blood of healthy people is 0.10 – 0.15 g/l (1.4 – 2.1 µmol/l).

Importance of the prothrombin complex

The deficiency of this factor can be either congenital or developed during life. Congenital prothrombin deficiency is not so common, that is, it is a rare pathology. Low prothrombin from birth is caused by a mutation of recessive genes located on chromosome 11.

With hypoproteinemia of any origin, as a rule, the level of this protein is also reduced. The diseased liver (hepatocytes are the site of formation of the main factors of the prothrombin complex) and K-avitaminosis (vitamin K is involved in the synthesis of FII and other factors called K-dependent) give a sharp drop in the concentration of this indicator.

Reduced prothrombin levels mean that blood will take longer to clot. To determine how the coagulation system works depending on the level of prothrombin, coagulation tests are used in clinical laboratory diagnostics, which allow one to have an idea of ​​​​the state of the entire prothrombin complex:

• PTI (prothrombin index, percentage);
• PO (prothrombin ratio, reciprocal PTI value, percentage);
• PTT (prothrombin time, in seconds);
• Prothrombin according to Quick (more sensitive analysis than PTI and PTV, in percentage);
• INR (international normalized ratio, percentage).

Excessive activity of prothrombin without any need is also fraught with various troubles, and sometimes even disaster for the body. Increased coagulability, the formation of clots that can close a vital blood vessel, can result in a dangerous situation, even death.

Rough tests and full analysis

The study of blood coagulation, as a rule, begins with indicative methods, which make it possible to detect a coagulation abnormality (prothrombin) without revealing its essence. Then, based on the results of the analysis of blood coagulation ability, other (already specific) methods are prescribed (PTT, INR, APTT and other hemostasiogram indicators).

As for the prothrombin test, it is a very important part of the coagulogram and can be presented in various forms. The deficiency of prothrombin complex factors (II, V, VII, X) is determined mainly by analyzing PTT according to Quick, which primarily reveals a violation of the external formation of thromboplastin. However, it is also possible to study these indicators separately using the principle of replacement samples.

Meanwhile, we cannot ignore the indicators of blood coagulation ability in women during the period of planning or pregnancy, because this allows us to calculate possible risks during childbirth. Keeping in mind these indicators during pregnancy, it is possible to anticipate and prevent bleeding (if PTT is prolonged) or the development of thrombosis and premature placental abruption if the blood exhibits a particularly high tendency to clot. During the period of labor itself, the prothrombin time is somewhat shortened compared to the norm, and the prothrombin index is increased. In women during pregnancy and childbirth, the study of blood coagulation function only with prothrombin complex indicators is not enough. In order to have a complete picture of the functional capacity of the hemostatic system, expectant mothers are prescribed the maximum coagulogram indicators.

Prothrombin time

Prothrombin time, as a laboratory test, allows clinicians to quickly assess not only the external hemostatic system, but also the entire cascade of blood coagulation reactions.

In emergency situations for the body (injuries with tissue damage, heavy bleeding, necrosis and other pathological conditions), a glycoprotein, a membrane protein - tissue thromboplastin, enters the blood, which indicates the activation of the reserve (external) hemostasis system.

Tissue (cellular) thromboplastin, called tissue factor (TF), interacting with coagulation factors (FVII) circulating in the bloodstream, sequentially includes other plasma thromboplastic factors in the process. This means that the hemocoagulation system is activated and the first phase of coagulation begins - the conversion of inactive prothrombin into active thrombin. Thrombin causes the enzymatic conversion of fibrinogen into fibrin, under its influence factors (V, VIII, IX, XIII) are activated, it destroys platelets, which causes (together with Ca ++) viscous metamorphosis of blood platelets, promoting the release of platelet factors.

The norm of PTT in adults ranges from 11–15 seconds (in newborns up to 3–4 days of life – 12–18, in premature infants – 15–20). In newborn full-term infants from 4-5 days of life, the prothrombin time corresponds to that of an adult.

This indicator is increased (clotting time is prolonged) in the following pathological conditions:

1. Liver diseases, because prothrombin synthesis occurs there;
2. Lack of vitamin K, the participation of which is necessary for the synthesis of K-dependent factors (including prothrombin);
3. DIC syndrome;
4. An increase in the level of factor III of the anticoagulation system (antithrombin), which blocks thrombin and other factors of the hemocoagulation system;
5. Increasing the fibrinolytic ability of blood (dissolving clots);
6. Pancreatic cancer;
7. Certain hematological pathologies (myeloid metaplasia);
8. HRD (hemorrhagic disease of the newborn);
9. High level of red blood cells in the blood (above 6.0 x/l);
10. Hemophilia B.

Whole blood taken with an anticoagulant (sodium citrate) is used as a biological material for studying prothrombin time using the one-stage Quick method (as the analysis is called).

PTT, Quick's test or thromboplastin time is an indicator of the external system of activation of factor II, where prothrombin time depends on the concentration in the blood plasma of fibrinogen, factors V, VII, X. The norm of PTT (Quick's test) is determined by the activity of thromboplastin and is seconds.

Prothrombin according to Quick

The definition of “prothrombin according to Quick” means the concentration of prothrombin complex factors as a percentage of the norm. This method is currently considered one of the most significant methods for studying prothrombin.

The test allows you to identify the activity of factors in the prothrombin complex of the patient’s blood when compared with the known PTT of “normal” plasma. This method is undoubtedly more informative compared to calculating the PTI. Prothrombin according to Quick determines FII in a patient, based on a calibration graph (the dependence of PTT on the total, total, activity of all participants in the reaction - factors of the prothrombin complex of diluted “healthy” plasma).

Normal prothrombin values ​​according to Quick vary within a wider range than PTI, and normally range from 75 to 140%. In women, the upper limits of normal are usually lower. The results of the analysis may depend on the age of the patient, the treatment he is taking (anticoagulants), and the sensitivity of the reacting substances.

Prothrombin according to Quick, first of all, decreases during treatment with indirect anticoagulants (INR increases in this case), therefore, when monitoring anticoagulant therapy, this fact should be kept in mind first of all and, taking it into account, the patient’s blood is analyzed in one way and in one CDL. Otherwise, you may obtain inadequate results that negatively affect the further course of anticoagulant therapy, if it is carried out at the time of the study.

Prothrombin values ​​according to Quick and PTI (prothrombin index) often give the same results in the normal range. As for the zone of low values, here the results vary noticeably, for example, you can get the following test answers: PTI - about 60%, and prothrombin according to Quick - 30%)

Prothrombin index

The prothrombin index (PTI) is the ratio between the clotting time of “healthy” plasma (control) and the clotting time of the blood of a sick person. The result is calculated as a percentage (PTT of normal plasma: PTT of patient plasma x 100%), the norm is from 90 to 105%. The inverse ratio (clotting time of the patient’s blood: clotting time of “healthy” plasma), expressed as a percentage, is called the prothrombin ratio (PR).

A low prothrombin index and prolonged PTT result in many pathological conditions:

• Congenital deficiency of certain blood clotting factors (II, V, VII, X);
• Damage to hepatocytes during a chronic pathological process localized in the liver parenchyma;
• Disseminated intravascular coagulation syndrome;
• Hemorrhagic syndrome caused by low plasma fibrinogen content (fibrinogenopenia);
• Impaired fibrinogen polymerization (dysfibrinogenemia);
• Vitamin K deficiency;
• Carrying out anticoagulant therapy;
• The use of clotting factor inhibitors, such as heparin, which inhibits the conversion of prothrombin to thrombin.

A high prothrombin index (shortened PTT) is observed in the following cases:

1. Formation of blood clots in blood vessels blocking blood flow as a result of various pathological conditions of the hemostasis system (thrombosis);
2. Consumption coagulopathies (DIC syndrome);
3. Excessive activation of the anticoagulant system, excessive formation of plasmin (hyperfibrinolysis), which leads first to bleeding, and then (with depletion of plasminogen) to thrombosis;
4. Liver diseases;
5. Increased activity of factor VII (traumatic tissue damage, necrosis);
6. Inclusion of protective mechanisms in women during childbirth.

Thus, prolongation of PTT will reduce the prothrombin index and indicate possible hypocoagulation (low blood coagulability, tendency to bleeding). And, conversely, a reduction in clotting time (PTT) increases the values ​​of the prothrombin index and indicates the presence of signs of hypercoagulation, that is, increased blood clotting (risk of developing thromboembolic conditions).

Unity and struggle of opposites

Disturbances in the hemostasis system lead to the development of coagulopathies, where pathology with a tendency to thrombosis is usually designated by the term “thrombophilia,” and diseases that are accompanied by increased bleeding are called “hemorrhagic diathesis.” Violations of blood coagulation abilities can be hereditary in nature or result from conditions formed during life (diseases of the liver parenchyma, vitamin K deficiency, the use of anticoagulants for medicinal purposes, activation of the fibrinolytic system).

The development of hemocoagulation disorder syndrome is caused by the loss (or decrease) of the ability of liver cells to biosynthesize coagulation factors. Moreover, it should be noted that the factors of the coagulation, anticoagulation and fibrinolysis systems do not exist in isolation; disruption of the activity of any one link leads to pathological conditions of other components. For example:

• A disorder in the biosynthesis of the protein we are considering, prothrombin, will certainly entail a disruption in the production of other factors (VII, IX, X) and a deficiency of all components of the prothrombin complex, which will subsequently result in a decrease in the activity of FV, an increase in the concentration of fibrin monomers, a decrease in the activity of FXIII and an increase in the ability of fibrin to lysis.
• Disruption of fibrinogen metabolism will cause a change in the structural structure of the profibrin layer of blood vessels, opening the way for the movement of red blood cells through the vascular walls.

The combination of seemingly completely opposite properties of the above systems (provided they are functioning normally) ensures the liquid state of blood, freely moving through all the blood vessels of the body, and its coagulation if there is a need to patch a gap formed as a result of tissue damage.

Research can be expanded...

If the described methods are not fully informative, studies of the hemostatic system can be expanded, for example, by studying individual functions and quantitative values ​​of platelet and plasma factors. The prothrombin test provides a basis for searching for various hemocoagulation disorders, suggesting the direction of further research. For this purpose, they resort to determining other parameters of the hemostasiogram:

1. The indicator of the transition of fibrinogen to fibrin (thrombin time);
2. INR (international normalized ratio;
3. APTT (activated partial thromboplastin time);
4. Determination of platelet factors (III);
5. Analysis of fibrinogen, SFMC (soluble fibrin monomer complex), D-dimer, lupus anticoagulant, etc.

These and many other laboratory tests make it possible to study not only the external path of hemostasis of a particular patient, but also make it possible to search for violations of the internal hemocoagulation system. However, the reader can obtain information about this in materials devoted to each of the listed indicators separately.

A prothrombin test is prescribed by a doctor to determine how quickly the blood clots. Prothrombin according to Quick very often makes it possible to identify serious pathologies in the body. Typically, such an analysis is prescribed for women in menopause, also for diseases of the gastrointestinal tract, liver, and in other cases. The methodology for this research was proposed back in the 30s of the last century by Quick. It is still popular today. The result of the study is expressed as a percentage.

Prothrombin according to Quick. What does it mean?

Proteins have a huge impact on blood clotting. The most important one in this case is prothrombin. The prothrombin molecule is synthesized in our liver. To successfully complete this process, the body must have normal amounts of microelements and vitamins, especially vitamin K. Research shows that a lack of this vitamin contributes to the formation of blood clots, which, in turn, interfere with proper blood circulation.

The degree of coagulation is characterized by the prothrombin index (PTI). It allows you to identify pathological processes in the body.

Prothrombin according to Quick is determined by the ratio of the temporary activity of prothrombin protein to the control sample. Expressed as a percentage. Characterizes prothrombin formation - the first phase of plasma homeostasis is shown, coagulation factor II is assessed.

Purpose of analysis

Prothrombin according to Quick is prescribed in the following cases:

• Frequent bleeding occurs or in case of injury the bleeding does not stop for a long time.
• Problems with the liver, kidneys, small intestines.
• Suspicion of blood cancer.
• Blood monitoring during anticoagulant treatment.
• Before the operation.
• Women during menopause due to hormonal changes to exclude cancer.

Most often, prothrombin indicators are of interest to specialists such as anesthesiologist-resuscitator, cardiologist, gastroenterologist, pulmonologist, pediatrician, traumatologist, surgeon, and therapist.

Prothrombin analysis according to Quick. Preparation for the procedure

The test for prothrombin does not require any special preparation, everything is the same as with other blood tests. But there are certain features:

• Blood is drawn on an empty stomach. The last meal is no later than eight hours before the procedure.
• A few days before donating blood for prothrombin according to Quick, you need to exclude fatty foods that are rich in vitamin K, and also avoid eating nuts, legumes, liver, cabbage, and green tea.
• Avoid alcoholic beverages, as consuming them destroys vitamin K, and this negatively affects test results.
• Before donating blood, you can only drink clean water, but only an hour before the procedure.

If you are prescribed a prothrombin blood test according to Quick, be sure to inform your doctor about all the medications you are taking. Some medications affect prothrombin levels. These include diuretics with heparin, antibacterial agents, aspirin, barbiturates, corticosteroids, and contraceptives. It should also be noted that if you are taking any sports nutritional supplements, some components of the composition may affect the tests.

Smoking is prohibited half an hour before the procedure. You need to relax and calm down. Negative emotions and physical activity negatively affect the result.

It is not advisable to determine prothrombin using Quick during menstruation; the results will be inaccurate.

Venous blood is examined for analysis. Capillary is not suitable for these purposes. The taken material is left for some time until the plasma separates. It is subject to various studies.

Determination of prothrombin

Prothrombin in the blood is determined in several ways:

• The most popular is prothrombin according to Quick. Provides more accurate information. Research shows percentages. The activity of plasma, the time during which it manages to clot, are determined during an analysis called prothrombin according to Quick.
• INR (International Normalized Ratio) shows the relative result. Most often, such a study is carried out when taking anticoagulants to monitor the condition.
• Prothrombin index. The procedure is considered obsolete. It is rarely used in medicine, since there are many more accurate analogues.
• Prothrombin time indicates the rate of blood clotting.

It is worth considering that INR shows relative results. This test is most often used by microbiologists. Prothrombin according to Quick gives extended results, accurate time and PTI.

Decoding, norm according to Kwik

When deciphering the analysis, researchers find out the PTI and the time during which the folding occurs, this indicator is indicated in seconds. A graph is drawn up for the result, indicating the percentage of coagulation readings. Each laboratory interprets the result in its own way; this may depend on the agents and the quality of the equipment, on how the patient used the drugs, on the characteristics of his treatment, on individual standards.

If prothrombin according to Quick is prescribed, the norm will be established, regardless of gender. The indicator is affected only by the state of the body. Normal prothrombin time is a period of 9-12 seconds, PTI in an adult is 82-142%.

This indicator is important during pregnancy; even with minor changes, the woman should be hospitalized. Deviations from the norm of prothrombin indicate disturbances in the body.

Increased performance

An indicator exceeding the norm indicates hypercoagulation. In cases of even minor deviations, it is necessary to conduct further examination and find out the cause. Having determined the appropriate cause for the violation of the prothrombin norm, the doctor can prescribe the correct treatment.

Elevated prothrombin levels may indicate the following problems:

• increased levels of heparin in the blood;
• formation of malignant neoplasms;
• blood clots in blood vessels;
• heart problems;
• congenital deficiencies of clotting factor II, V, VII, X;
• acquired deficiency of coagulation factors due to amyloidosis, nephrotic syndrome, liver dysfunction, chronic diseases;
• treatment with anticoagulants;
• presence of heparin;
• in chronic and acute leukemia - DIC syndrome;
• the use of antibiotics, laxatives, anabolic steroids, aspirin, quinidine, nicotinic acid, quinine, thiazide diuretics;
• long-term use of hormonal contraceptives.

Low rate

If prothrombin according to Quick is low, what does this mean? This may indicate hypocoagulation (tendency to bleeding), and it is caused by a lack of vitamin K. This vitamin is necessary for the synthesis of coagulation factors. Typically, vitamin K deficiency can occur with intestinal diseases and dysbacteriosis. Prothrombin decreases if there is a disturbance in the functioning of the liver, as well as the pancreas. The reason for the reduced rate may also be medications taken that can affect blood clotting.

Also, the reasons for low prothrombin include the following indicators:

• thrombosis and thromboembolism;
• polycythemia;
• dehydration, loss of fluid after diarrhea and vomiting;
• myocardial infarction or pre-infarction condition;
• jump, increase in the activity of clotting factor VII;
• injuries that caused large amounts of thromboplastin to enter the blood;
• cirrhosis, hepatitis;
• postpartum period;
• congenital deficiency of certain blood clotting factors;
• pronounced hereditary or acquired deficiency of fibrinogen in the blood.

Expansion of research

If the above methods do not provide complete information, the study of the hemostasis system is expanded. The doctor must study the individual functions, as well as the quantitative values ​​of plasma and platelet factors. Prothrombin tests provide grounds for searching for various disorders in hemocoagulation and suggest further avenues of research. For these purposes, the following hemostasiogram parameters are used:

• Thrombin time, or an indicator indicating the transition of fibrinogen to fibrin.
• International normalized ratio.
• Platelet factors are determined.
• Determination of activated partial thromboplastin time.
• Analysis of soluble fibrin-monomer complex, lupus anticoagulant, D-dimer and others.

The listed laboratory tests make it possible not only to study the external path of hemostasis of a certain analysis, but also make it possible to find disturbances in the internal hemocoagulation system.

How to increase prothrombin

If studies have shown that prothrombin according to Quick is low, the attending doctor will give recommendations for its correction. He will recommend including natural foods containing vitamin K in your diet. It will be necessary to normalize your water balance, optimize the consumption of clean water, the norm must be increased to two liters per day.

Eat foods that help improve blood clotting. These include cabbage (cauliflower and regular), spinach, carrots, corn, walnuts, bananas, red berries. In such cases, buckwheat porridge, animal fats, legumes, liver, and white bread are useful. These products should be on the menu every day. At the same time, the diet should be full of other vitamins and microelements; you will only supplement it with the listed products.

In order to prevent bleeding, the doctor recommends eliminating decoctions based on nettle, tansy and yarrow.

Decreased prothrombin

Many people wonder how to lower prothrombin according to Quick. To slightly reduce the rate, a diet that should contain tomato juice, tomatoes, garlic, onions, oatmeal, flaxseed, and olive oil is suitable. Recommended for consumption are seafood, fish, as well as fruits and berries: lemons, cherries, raspberries, cranberries, strawberries.

Increased prothrombin is a signal that the blood is too thick. This negatively affects the functioning of the heart, threatens the formation of blood clots, and generally has a negative effect on the condition of the body. There are medications that reduce blood density, but if for some reason they are contraindicated? For example, pregnant or breastfeeding women.

The following recipe will help:

• Take three sweet and sour apples, two tablespoons of pure green tea, one tablespoon of honey.
• Cut the apples into thin slices, put them in a thermos (1.5-2 l), add tea and add honey. Pour hot water (90 degrees), not boiling water, and leave for three hours.
• Make an infusion early in the morning and drink throughout the day. So every morning for a week we make a drink and drink it. We check the prothrombin level using tests.

Update: November 2018

The blood coagulation system is one of the most important protective functions of our body. Under normal conditions, when the body is not in danger, coagulation and anticoagulation factors are in balance and the blood remains a liquid medium. But if a vessel is damaged, a whole cascade of reactions is immediately launched, programmed to form a blood clot and block the damage.

What is the coagulation system

The hemostasis system is very complex, involving many tissue and serum factors. Its launch is really similar to a cascade: it is a chain of reactions, each subsequent link of which is accelerated by additional enzymes.

A simplified blood coagulation scheme looks like this: thromboplastin is released from the damaged endothelium, with the participation of calcium ions and vitamin K, it activates prothrombin. Prothrombin is converted to active thrombin, which in turn triggers the formation of insoluble fibrin from soluble fibrinogen. This process is completed by the stage of retraction of the blood clot, that is, its compaction and the actual blockage of the damage.

At each stage, many more factors are involved in this scheme. In total, there are 13 plasma and 22 platelet types.

What is prothrombin

This is a glycoprotein produced in liver cells, plasma coagulation factor II.

The synthesis of prothrombin requires vitamin K, so one of the reasons for its decrease is insufficient intake of this vitamin from food or a low level of its synthesis in the intestines.

Prothrombin is an inert protein, its activation occurs under the influence of coagulation factor XII (internal system) or when the endothelium is damaged (external mechanism of hemostasis).

In practice, qualitative tests for prothrombin are used, which reflect its content in the blood only indirectly. They are based on calculating the period of time during which the blood clots when thrombokinase activators are added to it (which in turn activates prothrombin, converting it into thrombin, and thrombin catalyzes the conversion of fibrinogen into fibrin).

Therefore, when we say “test for prothrombin”, “blood for prothrombin”, this does not mean determining its concentration in the blood, as, for example, glucose, hemoglobin or bilirubin are examined. And the result is given not in quantitative units, but as a percentage. This concept characterizes the external mechanism of hemocoagulation as a whole and reflects the activity of the entire prothrombin complex (factors II, V, VII, X).

How are prothrombin tests performed?

The essence of almost all methods for studying the activity of the prothrombin complex is to calculate the time of formation of a fibrin clot immediately after adding activators to the blood, as well as comparing this time with normal values.

Blood is drawn into a test tube with an anticoagulant (sodium citrate). The test tube with citrated blood is slightly heated in a water bath. A reagent consisting of thromboplastin and calcium chloride is added to it. The time of loss of fibrin fibers is measured using a stopwatch. This is prothrombin time (PT). Its normal value is 11-15 seconds.

Having determined the patient's PT, it is compared with the normal prothrombin time (PT). It is usually indicated on the reagent bottle and depends on the activity of the thromboplastin used. Usually this figure is from 12 to 18 seconds (it may be different in each new reagent sample). The ratio of PVN to PT of the subject, expressed as a percentage, is the prothrombin index (PI). Its normal value is 80-105%. The longer the blood clotting time (PT), the lower the PI, which will indicate hypocoagulation.

Prothrombin according to Quick

The test is also based on the ratio of the patient's normal prothrombin time to the patient's PT, expressed as a percentage. But the method is considered more accurate. For the study, several dilutions of plasma are used (1:2, 1:3,1:4) and the construction of a calibration graph. For each dilution, the PT is determined and marked on the graph.

Prothrombin rates according to Quick are from 75% to 140%.

Within the normal protein content, the Kwik and PTI results may be identical. At low contents, these indicators sometimes diverge.

Another indicator - INR (international normalized ratio). It is mainly used to assess the effectiveness of anticoagulants. This indicator is calculated using the formula:

INR=(patient PT/normal PT)*value of the international thromboplastin sensitivity index (ISI).

This index is indicated on each package of the reagent. INR allows standardization of the results of PT and IPT performed in different laboratories. The INR value in healthy individuals is 0.8-1.2.

The numbers of prothrombin according to Quick and INR are inversely proportional to each other: if prothrombin according to Quick is increased, then the INR is reduced and vice versa.

When is prothrombin tested?

A coagulation test (coagulogram) is not a routine examination; it is not prescribed to all patients in a row. The test is carried out in the following situations:

• The presence of symptoms indicating problems with clotting: frequent nosebleeds and other bleeding, bruising for no apparent reason, bleeding gums when brushing teeth, hemorrhagic rash on the skin.
• Thrombophlebitis of the veins of the lower extremities.
• Examination of the patient before any surgical interventions.
• Pregnant women must be examined.
• Control during treatment with anticoagulants. They are prescribed to patients with arrhythmias, after valve replacement, and for thrombophlebitis. The purpose of these drugs is to increase blood clotting time, but keep it within a safe range. In this case, PT will be increased by 1.5-2 times, PTI and prothrombin according to Quick will be reduced, INR will be increased (safely up to 2-3).
• For liver diseases to clarify its functional insufficiency.
• Before prescribing estrogen-containing hormones, as well as during their use.

Prothrombin norms in different groups of patients

The levels of this glycoprotein in the blood vary somewhat among different age groups. In children under 18 years of age, its normal content ranges from 80 to 110%, in adults – from 78 to 145%.

The norms for adult men and women are no different. A moderate increase in prothrombin may occur in women before childbirth.

Prothrombin index

This indicator is determined in all coagulograms. What does prothrombin index mean?

The normal prothrombin index is 80-105%. The greater the patient’s PV compared to normal, the lower his PI will be and vice versa. Accordingly, a low index indicates poor coagulability, and a high index indicates hypercoagulation (propensity for thrombosis).

The prothrombin index test is prescribed in the same situations as the Quick prothrombin test. Basically, both of these values ​​are in direct correlation and in the range of normal content can be the same.

The norm of the prothrombin index during pregnancy differs slightly by trimester:

• I trimester – 80-119%
• II – 85-120%
• III – 90-130%.

How to decipher a coagulogram

This analysis is carried out in order to obtain answers to the questions:

• does the blood clot normally?
• is there a risk of postoperative or postpartum hemorrhage;
• what is the cause of frequent bleeding and bruising;
• what dose of anticoagulants is safe if their use is necessary.

Blood hypocoagulation and tendency to bleeding will be indicated by:

• reduced prothrombin according to Quick (less than 75);
• decreased prothrombin index (less than 80);
• increased prothrombin time (more than 18 seconds);
• increased INR (more than 1.3).

Hypercoagulability and tendency to form blood clots is characterized by:

• increased prothrombin index (more than 110);
• increased prothrombin (above 145);
• shortening of PT (less than 10 s);
• decrease in INR value less than 0.8.

The main reasons for the decrease in prothrombin

We remember that prothrombin is a protein that is formed in liver cells with the participation of vitamin K. It becomes active with the help of several tissue and plasma clotting factors. The gene responsible for normal prothrombin synthesis is recessive and is located on chromosome 11.

In addition, there are also anticoagulant factors in the blood, the increased activity of which can inhibit the components of the prothrombin complex.

The main causes of low prothrombin and IPT (PT and INR are increased) follow from this physiological mechanism:

• Congenital pathology - changes in the genes responsible for the synthesis of prothrombin (quite rare).
• Liver diseases accompanied by decreased function or death of hepatocytes: chronic hepatitis, cirrhosis. The insufficiency of structural units for synthesis leads to the fact that prothrombin in the blood is reduced.
• Vitamin K deficiency. This happens both when there is insufficient intake from food, and when its absorption and synthesis in the intestines is impaired. Therefore, gastrointestinal diseases accompanied by dysbiosis and impaired fat absorption can also lead to its deficiency.
• Reduced levels of blood clotting factors V, VIII, X.
• Autoimmune diseases, including the production of antibodies to prothrombin (more precisely, to the phosphatidylserine-prothrombin complex).
• Low fibrinogen levels.
• 2nd phase of DIC syndrome (exhaustion phase).
• Increased activity of the anticoagulant factor antithrombin III.
• Treatment with anticoagulants (heparin, fraxiparin, warfarin, neodicoumarin).

Reasons for increased prothrombin and PTI

An increase in PTI indicates hypercoagulation and is dangerous for the development of thrombosis (heart attacks, strokes, thrombosis of the veins in the legs, pulmonary embolism). This condition is especially unfavorable after operations and after childbirth.

• Last weeks of pregnancy.
• DIC – syndrome (1st stage).
• The use of estrogen-containing hormones by women (and sometimes men).
• Congenital thrombophilia.
• Excess vitamin K.
• Mutation of the prothrombin gene G20210A (carriers of the defective gene are 2-3% of the population).
• The period after severe operations, burn disease.
• Postpartum stage.
• Malignant tumors.
• Antithrombin III deficiency.
• Antiphospholipid syndrome.

What to do with indicators that do not fit into the norm?

Prothrombin is increased or decreased, what to do?

First, you need to see a doctor. Many people think that the answers to all questions can now be found on the Internet. In fact, this is far from the case. This is especially true for the coagulation system. The information presented on the Internet about this matter is very confusing and 50% of it is completely wrong. This indicates the high complexity of this issue.

Which doctor should I contact?

To the one who ordered the analysis. If you took a coagulogram on your own, first we go to a therapist.

What should you definitely tell your doctor?

• You must list all medications that you are taking or have taken recently, including dietary supplements. Many medications tend to affect coagulogram parameters, and this applies not only to anticoagulants. So, may lower prothrombin Nevigramon, Streptomycin, Tetracycline, Levomycetin, L-thyroxine, vitamin A, Aspirin in high doses.

Increase PTI may: contraceptive hormonal drugs, caffeine, antihistamines, high doses of vitamins C, K, corticosteroid hormones.

• Long-term alcohol abuse can also reduce PTI.
• An excess of foods rich in vitamin K in the diet can lead to an increase in prothrombin, and insufficient consumption of them can, on the contrary, lead to a decrease. These are foods such as greens, green vegetables and fruits, liver.
• Women must be informed about their pregnancy.

What additional examinations can be prescribed?

• Liver function test (advanced biochemical analysis with determination of bilirubin, liver transaminases, total protein, albumin).
• Ultrasound of the liver and biliary tract.
• Fibroelastography of the liver for suspected cirrhosis.
• Determination of antibodies to viral hepatitis.
• Extended examination of the coagulation system (APTT, fibrinogen, thrombin time, D-dimers, plasminogen, antithrombin III, plasma fibrinolytic activity, lupus anticoagulant, etc.)
• Intestinal examination (stool analysis for dysbacteriosis, colonoscopy).

How to lower or increase the prothrombin index?

If the readings are only slightly outside the normal range, there is no need to panic. It is possible that some time after stopping some medications, a repeat test will not reveal any abnormalities. Many women are concerned about the question - what to do with taking contraceptives? If cardiovascular diseases are diagnosed, definitely stop taking it, but if the woman is generally healthy, the pills can be taken, but the analysis should be periodically monitored.

You can also try to correct PTI with a diet if you are sure that your diet is clearly lacking foods such as greens (parsley, dill, spinach), vegetables (cabbage, broccoli), beef or pork liver. Green tea improves PTI quite well.

If prothrombin levels are elevated and there is a risk of thrombosis, doctors usually prescribe anticoagulants. At the same time, only warfarin will clearly reduce this indicator. New generation anticoagulants (Pradaxa, Xarelto, Eliquis and others) act on other coagulation factors, but the level of prothrombin may not change.

Aspirin also does not change this indicator, but taking it in small doses makes sense to reduce the risk of blood clots.

In what cases should you not waste time on a diet?

• If the coagulogram values ​​are significantly higher or lower than normal.
• There are symptoms of impaired homeostasis: recurrent bleeding or thrombosis.
• Presence of pregnancy.
• Abnormal coagulogram in a child.
• There are other symptoms (yellow skin, dark urine, swelling, rash, itchy skin, etc.)

In these cases, you need to undergo a full examination and find out the cause of the pathology of the coagulation system.

Prothrombin index (PTI)- one of the indicators of a blood test that characterizes the hemostasis system (), which occurs with the participation of special proteins called coagulation factors. The process is activated by the protein prothrombin, which is formed in the liver with the help of vitamin K.

The essence of the study is to determine the clotting time of a certain person’s blood, as well as standard plasma, and express this ratio as a percentage.

Hemostasis system

• Studies of the hemostasis system are of primary importance in the diagnosis of various types of bleeding, thromboemolic syndromes, thrombotic conditions and processes of disseminated blood coagulation, including shock conditions and burns.
• Blood coagulation system ensures the maintenance of blood in a liquid state, while taking part in stopping bleeding, as well as the normal condition of the vascular wall.
• It is ensured by the counteraction of two systems: coagulant, which is a series of complex reactions using enzymes between protein folding factors, and anticoagulant, which, on the contrary, does not allow this process to develop and prevents the formation of clots and, as a result, blood clots from the blood.
• Part of the coagulation system there are proteins called blood clotting factors. They are numbered from 1 to 12. Prothrombin is the most important component. This protein is factor 2. It is a precursor to the active enzyme thrombin.
  When it acts, a clot is formed(thrombus), which closes the wound and stops bleeding. Its normal level shows that the body is able to effectively cope with the timely stop of bleeding. Therefore, determining this indicator is very important.

Briefly about blood clotting

There is a mechanism necessary to stop bleeding, or rather to form a blood clot (coagulation hemostasis), aimed at the formation of an important component - fibrin.

This mechanism is provided by 12 factors:

1. fibrinogen;
2. prothrombin;
3. tissue thromboplastin;
4. calcium ions;
5. labile factor (proaccelirin);
6. little studied factor;
7. proconvertin (stable factor);
8. antihemophilic globulin A;
9. Christmas factor (plasma thromboplastin) is an antihemophilic factor C. It is determined for the diagnosis of a complex disease - hemophilia.
10. prothrombinase;
11. Hagen factor (contact factor);
12. fibrin stabilizing factor.

For laboratory screening of the coagulation system, it is customary to determine the second factor - prothrombin.

The coagulation system in the human body functions very reliably. Thus, when 10 ml of blood clots, 300 units of thrombin are formed, which is enough to clot 5 liters of blood.

Its functions are:

• preventing activation of coagulation factors;
• neutralization and blocking of active coagulation factors;
• stopping platelet activation;
• lysis (cleavage) of fibrin that was formed during the coagulation process.

The anticoagulant system includes substances that are synthesized genetically, as well as body components that are formed during the process of coagulation and fibrinolysis of coagulation factors; the function of these substances is to neutralize and inhibit active coagulation factors. Anticoagulants can be proteins or lipids.

The mechanism of action is divided into:

1. antithromboplatins,
2. antithrombins,
3. antifibrins.

• To assess the hemostatic system it is necessary to determine both the activity and the amount of cellular and plasma components of this system in the circulating blood.
• At the same time, a decrease in function (activity) the above components, which depends on many reasons, can cause clinical manifestations (thrombosis or bleeding), sometimes even in the absence of a quantitative deficiency (impaired production or exhaustion - in DIC syndrome).
• Accurate diagnosis of disorders determines the tactics of corrective therapy. In this case, the need to use pharmaceuticals aimed at stimulating or, conversely, inhibiting the impaired activity is determined. Replenishment of the quantitative deficit is possible by substitution with drugs or hemocomponents.

How is the indicator determined?

To perform the test, you need to take a routine blood test from a vein.

There are two methods for determining PTI: Quick test and routine laboratory testing.

Quick's prothrombin test characterizes the process of blood coagulation, making it possible to evaluate the activity of prothrombin and accelerators of its conversion - factors of the prothrombin complex and heparin-like substances. The activity of prothrombin complex factors is expressed as a percentage, normal fluctuations correspond to 80-100%.
Prothrombin index and time– the main parameters that are determined.

Prothrombin index indicators

So, according to Quick, PTI is from 78 to 142%, and according to other methods - from 95 to 100%. The obtained analysis figures are influenced by such indicators as the person’s age.

Changes in the hemostatic system in different age periods:

• In newborns blood clotting is slow. This is especially pronounced on the second day of life. The low content of the main blood clotting factors in the blood is determined to a large extent by the functional immaturity of the liver and insufficient formation of vitamin K by the microflora of the colon.
• During the first year of life The concentration of certain facts in the blood increases, but it reaches adult levels only during puberty.
• In older people You should expect thickening of the blood (this is due to an increase in the number of platelets and increased clumping).

When is a prothrombin index test prescribed?

What else do you pay attention to when analyzing for PTI?

There are cases when determining this indicator alone is not enough to make a diagnosis or prescribe adequate drug therapy.

In such cases, they are considered in conjunction with other indicators of the blood coagulation system, namely:

Normal indicators in women

• For women, the norm of prothrombin index the same as for males and is 95-100%. The exception is the period of pregnancy, especially the last trimester, when the level of the indicator increases. The normal level of IPT during pregnancy is considered to be 100-120%.
• In this case, it is necessary to monitor the system blood clotting, take a coagulogram test, since it is very important to determine the state of the blood when preparing for childbirth. By assessing one of the indicators, such as PTI, it is possible to foresee the risks of complications during or after childbirth, namely the likelihood of bleeding.
• Early detection of this possibility makes it possible to prevent the development of a pathological condition through the use of certain medications, the point of application of which is the effect on the coagulation system.

Reasons for deviation from the norm

There are a number of body conditions when PTI levels can fluctuate. Depending on the level: with increased or decreased PTI numbers, one can judge the presence of a pathology such as hyper- and hypocoagulation.

A condition such as hypercoagulation, or a symptom of increased blood clotting, can be triggered by factors:

• excess vitamin K in the body (since this vitamin is needed for the formation of prothrombin);
• malignant neoplasms, various types of tumor processes;
• in patients after myocardial infarction, as well as coronary artery bypass grafting;
• in the postoperative period after heart surgery, valve replacement;
• in patients suffering from atrial fibrillation for a long time and not taking antiplatelet agents;
• physiological increase is observed in pregnant women (especially in the last trimester);
• for liver diseases;
• sometimes when using hormonal contraceptives, steroid drugs, adrenal hormones;
• for thromboembolic complications, vein thrombosis;
• in the chronic course of varicose veins.

Decline prothrombin level ( hypocoagulation) is considered not a particularly good prognostic phenomenon.

This provokes:

• acute inflammatory processes of the liver - hepatitis;
• damage to the structural organization of the liver (sclerosis, fibrosis, cirrhosis of the liver);
• use of anticoagulant drugs (warfarin, aspirin);
• vitamin K deficiency (due to dysbiosis or diseases of the gastrointestinal tract, when absorption processes are disrupted);
• lack of active fibrinogen.

What to do with increased PTI?

In this case, there is a possibility of bleeding, since without the required amount of prothrombin factor, coagulation will be ineffective, as evidenced by a violation in the cascade of reactions.

Such people should definitely consult a doctor about the frequency of IPT monitoring, especially if there is severe concomitant pathology.

It is necessary to take medications if surgical interventions are necessary, be it abdominal surgery or minor cosmetic interventions. It is imperative to notify the doctor about the status of the tests when visiting the dentist, since tooth extraction can cause prolonged heavy bleeding.

How to take a blood test for PTI

To obtain accurate research results, a number of rules must be followed. The test is taken on an empty stomach, in the first half of the day. You are allowed to drink a few sips of water. It is recommended the day before, about 24 hours in advance, to refrain from consuming fatty, fried, smoked foods, as well as alcoholic beverages.

How to lower the prothrombin index?

The first thing you need to do is consult with a hematologist by visiting a specialized institution. The pharmaceutical market presents a lot of drugs for correcting the hemostasis system. However, it is important to choose the correct dosages, and you need to repeat the analysis at a certain time and, depending on the results, change the dosage of the drug.

What to do if the PTI is low?

Description

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One of the most important laboratory indicators of a coagulogram characterizing the state of the coagulation system.

A coagulation test in which the clotting time of the patient's plasma is determined after adding a mixture of tissue thromboplastin and calcium ions to it.

Determination of prothrombin time and prothrombin according to Quick is a way to assess the deficiency of prothrombin complex factors and the activity of the extrinsic coagulation pathway. The test results, with normal content and quality of fibrinogen, depend on the content of factors II, V, VII, X (activity of the prothrombin complex). The formation of the main factors of the prothrombin complex occurs in the liver, so this test is often used to assess its protein synthesizing function. The synthesis of these coagulation factors in the liver depends on the presence of vitamin K in the body, the antagonists of which are indirect anticoagulants or indirect anticoagulants (ANDA), therefore the prothrombin test is used to monitor therapy with indirect anticoagulants.

The most commonly used AEDs are 4-hydroxycoumarin derivatives - monocoumarols (phenprocoumarol, acenocoumarol), among which warfarin (synonyms - Aldocumar, Athrombin - K1, Cofarin, Coumadin, Coumadine, Cumatox, Omefin, Orfarin, Marevan, Panwarfin, Prothromadin, Warfilone, Warnerin).

Prothrombin test results can be presented in various forms

1. Prothrombin according to Quick (%) - like the prothrombin index, allows you to determine the activity of the prothrombin complex of the patient’s plasma in comparison with the measured prothrombin time of the control plasma. But in this case, the calculation is carried out according to the curve of the dependence of prothrombin time on the % content of prothrombin complex factors, constructed using different dilutions of control plasma. This way of presenting results is more accurate, especially in the low value range. The prothrombin index and Quick prothrombin may coincide with each other in the range of normal values. In the area of ​​low values ​​recommended for the management of patients taking indirect anticoagulants, the performance of these tests diverges. A prothrombin index of 50 - 60% can correspond to 30 - 40% prothrombin according to Quick. Calculation of prothrombin according to Quick is currently a generally accepted method.

2. INR (International Normalized Ratio), Latin abbreviation INR (International Normalized Ratio) is an additional way of presenting the results of a prothrombin test, recommended for monitoring therapy with indirect anticoagulants by the WHO expert committee, the International Committee for the Study of Thrombosis and Hemostasis and the International Committee for Standardization in Hematology.

INR is calculated using the formula: INR (INR) = (Patient's prothrombin time / Normal mean prothrombin time)isi,

where ISI (International Sensitivity Index of thromboplastin), also known as MICH (International Sensitivity Index) is an indicator of the sensitivity of thromboplastin, standardizing it relative to the international standard. INR is a mathematical correction that standardizes prothrombin time measured using various thromboplastins with different sensitivities. The optimal INR limits that should be achieved during treatment with indirect anticoagulants depend on the therapeutic goals and are determined by the attending physician. INR and prothrombin according to Quick correlate negatively - a decrease in prothrombin according to Quick corresponds to an increase in INR.

3. Prothrombin time (in seconds) reflects the clotting time of plasma after the addition of thromboplastin-calcium mixture. This presentation of the result of the prothrombin test does not allow for a comparative assessment of the results, since different laboratories use different methods and equipment, and most importantly, thromboplastin of different activity and different origin.

4. Prothrombin index - the ratio of the clotting time of the control (“normal”) plasma to the clotting time of the patient’s plasma, expressed in %. The indicator in the low range depends significantly on the sensitivity of the reagents used.

In INVITRO, the result of the prothrombin test is described in the form of 3 indicators: prothrombin time, prothrombin according to Quick (%), INR.

Preparation

Patients being treated with indirect anticoagulants - vitamin K antagonist drugs (warfarin) must strictly adhere to the medication regimen and regularly monitor prothrombin and INR. Before the study, the entire daily dose of the drug should be taken once between 16 and 17 hours, unless otherwise recommended by the attending physician. The time interval between the last dose of the drug and the collection of the material should be constant. It is preferable to take blood in the morning on an empty stomach, after 8-14 hours of overnight fasting (you can drink water), or 4 hours after a light meal during the day. On the eve of the study, it is necessary to exclude increased psycho-emotional and physical stress (sports training), and alcohol intake.

Indications for use

Study of blood coagulation pathology.

Screening study of the state of the coagulation system.

Control of blood clotting during long-term treatment with indirect anticoagulants (coumarins, etc.).

Study of liver functions - assessment of the synthesis of prothrombin complex factors in the liver.

Interpretation of results

Interpretation of research results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. The doctor makes an accurate diagnosis using both the results of this examination and the necessary information from other sources: medical history, results of other examinations, etc.

Units of measurement and conversion factors:

• Prothrombin time: seconds
• Prothrombin according to Quick: %
• INR: no units

Reference values:

• Prothrombin time: 10.0-13.2 sec
• Prothrombin according to Quick: 80-133%
• INR: When using the indicator to monitor therapy with indirect anticoagulants, the optimal target INR limits depend on the clinical situation and therapeutic goals and are determined by the attending physician. INR and prothrombin according to Quick correlate negatively - a decrease in % prothrombin according to Quick corresponds to an increase in INR.

hereditary deficiency of factors I, II, V, VII and X;

medications - vitamin K antagonists (anticoagulants - phenylin, etc., coumarins and drugs that enhance their effect: anabolic steroids, clofibrate, glucagon, thyroxine, indomethacin, neomycin, oxyphenbutazone, salicylates; heparin, urokinase/streptokinase), direct inhibitors of coagulation factors ( rivaroxaban, apixaban - X factor inhibitors);

false distortion of the result due to preanalytical errors (taking blood above the mark on the container with an anticoagulant, taking blood below the mark - inadequate ratio of plasma volume to anticoagulant, problematic collection and activation of coagulation before mixing the sample with the anticoagulant, etc.)