Prothrombin according to Quick is low. Analysis and interpretation of results

Indicators below normal are a reason to prescribe coagulants.

A decrease in PC during pregnancy threatens a woman with thrombosis, blockage of blood vessels and related complications. In such situations, doctors usually prescribe anticoagulants - thinning drugs (warfarin).

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What it is? Prothrombin is a protein involved in the blood clotting mechanism; its synthesis occurs in the liver with the participation of vitamin K. Clotting involves the transition of blood from a liquid to a thick state.

To function comfortably in the body, blood must have a liquid consistency. When blood vessels are damaged, a process of coagulation—thickening—must occur. The body cannot lose a large volume of blood and clog the vessels with numerous blood clots.

• Laboratory analysis for prothrombin allows you to assess the quality of the coagulation mechanism.

Like any analysis, a prothrombin test is taken on an empty stomach. Patient who cannot perform this condition for health reasons, eats 4-5 hours before the procedure. Drugs that affect blood clotting cannot be taken before the test - the results will be far from the truth. If you refuse medicine If it doesn’t work, notify your doctor about taking it.

An analysis of the quality of blood clotting is necessary when the following diseases and suspicion of their presence:

• Antiphospholipid syndrome in pregnant women (it is manifested by miscarriages, frozen pregnancies, placental insufficiency and other obstetric complications);
• Liver pathologies;
• Atherosclerosis, varicose veins;
• Imbalance of vitamin K in the body;
• Presence of autoimmune diseases;
• Long-term use of indirect anticoagulants.

The prothrommin test may also be prescribed for other diseases to screen for coagulation. Under a microscope, the natural mechanism of blood clotting is recreated.

Potassium ions and thromboplastin are added to recalcified plasma. The prothrombin complex has several coagulation factors - the analysis allows us to identify a deficiency or surplus of such factors.

Prothrombin time - what is it? (norm)

Prothrombin time is the period of blood clotting from the moment a mixture of potassium and thromboplastin is added to the plasma. Thromboplastin, used in laboratories, has a certain level of sensitivity to factors II, V, VII and X.

The normal prothrombin time is from 11 to 16 seconds, but the activity of the substance may vary depending on the sample. Accordingly, draw conclusions by comparing general meaning The result in seconds is incorrect. A relative assessment is required.

Prothrombin index - what is it? (norm)

The prothrombin index is the ratio of the fixed normal blood clotting time to the patient’s individual indicator. The prothrombin index can be determined more accurately using the INR (international normalized ratio) analysis.

The prothrombin index mathematically corrects the prothrombin time. The individual result in seconds is divided by a fixed rate healthy person and multiplied by the sensitivity coefficient of the taken thromboplastin. The number of the latter is from 1 to 3; it can be found in the universal international classification.

Remember, when determining the prothrombin index: the norm for women and men is the same - from 0.8 to 1.3. But the rate may vary depending on age and health status.

The results of the preoperative study should not go beyond 0.85 - 1.25. An indicator of 3.0 - 4.0 is observed in a patient who has suffered a myocardial infarction or suffers from serious cardiovascular diseases.

The normal prothrombin index is 2.0 – 3.0 in the case of:

• Heart valve defects;
• Chronic atrial fibrillation and taking Warfarin against its background;
• Treatment of venous thrombosis and prevention of deep vessel thrombosis after surgery;
• Implantation of mitral and aortic valve prosthesis;
• Treatment of thromboembolism in the pulmonary artery area.

A prothrombin index according to INR above 6.0 requires urgent hospitalization of the patient. This coefficient indicates high risk internal bleeding in various locations.

The situation becomes more complicated if a person has already had ulcerative lesions of the gastrointestinal tract, renal failure, hypertension and blood flow disorders in the brain. In this case, the potential risk of hemorrhagic (bleeding-related) infarctions in organs increases.

If unsatisfactory results of the analysis using the INR system are obtained, a repeat study is not required (the result is very sensitive and reliable). The index values ​​do not differ depending on the type of laboratory material taken (capillary, venous blood).

• The prothrombin index is calculated taking into account the sensitivity of thromboplastin to blood clotting factors.

Prothrombin according to Quick - what is it? (decreased, increased and normal)

For several decades, prothrombin has been calculated in laboratory conditions using the Quick method. What it is? This is the percentage expression of prothrombin activity. The scientist proposed to compare the patient’s prothrombin time with the indicator of the dependence of this period of time on the number of prothrombin complex factors in the taken plasma. The result is a percentage.

The construction of the dependence allows you to very accurately estimate the coagulation index, but the sensitivity coefficient of thromboplastin is not taken into account.

This feature of the test affects the quality of the result in the area critical values below and above normal. IN standard results and minor deviations from them, the INR and Quick indexes are directly proportional.

• The test results card in any laboratory will contain prothrombin according to Quick. The norm is in the range of 78% - 142%. The indicator may be slightly higher than the average, but it should be within normal percentages.

IN healthy body Blood clotting is often increased - hypercoagulation is observed. This process is considered normal until a person develops any vascular diseases or chronic tissue damage. Their presence becomes a risk of blood clots.

Regular screening is necessary after blood thinning medications are prescribed. In some cases, a depot (the stage of accumulation of a substance) can form in the body from these drugs, which will lead to a state of hypocoagulation with increased bleeding.

In addition, the analysis results may also contain opposite process– hypercoagulation (increased coagulation activity). Indicators of insufficient blood density are observed much less frequently than excess blood density.

• However, any pathology of prothrombin factors requires control or even treatment.

Increased prothrombin in men and women

Prothrombin in men and women over 45-50 years of age is often increased - more than 142% according to Quick. Hypercoagulation can be caused both by the presence of vascular diseases and by temporary factors. The latter include:

• Imbalance of vitamin K, what interferes proper synthesis prothrombin in the liver, where it is normally formed;
• Chronic liver diseases and disorders of its functioning, which also interfere with the normal synthesis of prothrombin;
• Congenital anomalies: deficiency of blood coagulation factors II, V, VII, X;
• The presence of a heparin inhibitor in the coagulation mechanism;
• Nephrotic syndrome, amyloidosis (deposition of a special pathological protein in organs);
• Taking antiseptic, laxatives, anabolic drugs, hormonal drugs, nicotine and acetylsalicylic acid, quinine, quinidine.

Increased prothrombin not due to the above factors indicates the presence of serious illnesses. Thus, the diagnostic search is based on the following nosologies:

• Thromboembolism (blockage of blood vessels with blood clots);
• Polycythemia (increased number of red blood cells in the blood, including in connection with oncological processes);
• Oncological diseases: leukemia, cancerous tumors various localizations;
• Pre-infarction state of the body;
• Myocardial infarction.

Prothrombin in women may be increased due to long-term use hormonal contraceptives, especially with an increased dosage of the estrogen component (from 30 to 50 mcg per tablet).

If the patient has serious vascular disease, birth control pills needs to be cancelled. Possible transition to hormonal drugs local impact(suppositories, vaginal ring).

Diet does not significantly affect blood clotting. You can reduce the Kwik score by several percent by adding “oxidizing” foods to your daily menu. Increased result causes lack of diet fermented milk products, red and black berries, citrus fruits, fatty varieties fish and the amount of water drunk.

Low prothrombin - what does it mean?

Low prothrombin is observed during hypocoagulation. This result indicates the body’s tendency to internal bleeding. A deficiency of coagulation factors occurs in the following situations:

• Vitamin K deficiency is a violation of prothrombin synthesis;
• Congenital deficiency certain factors regulation of processes in the blood;
• Pathologies of the liver that interfere with the normal synthesis of coagulation factors;
• Lack of fibrinogen in the blood (congenital and acquired);
• Taking medications that reduce the blood's ability to clot.

A low prothrombin level indicates the following diseases:

• Dysbacteriosis;
• Pathologies of the gastrointestinal tract;
• Prothrombin deficiency;
• Hypovitaminosis.

You can correct a slightly reduced prothrombin level with the help of foods containing vitamin K. Cabbage, carrots, bananas, apples, pears, spinach and lettuce will be useful.

The reason for poor results in diet concerns men more often than women. It is the male gender that prefers meat products vegetables. As a result of such addictions, a deficiency of vitamins appears in the body.

Prothrombin during pregnancy

For pregnant women, a test for prothrombin index is done in mandatory. During childbirth low rate can lead to heavy bleeding, and high - to premature contractions and even late miscarriage.

Therefore, it is very important to evaluate this indicator during gestation, especially if there are various complications both during this pregnancy and during the previous one.

During gestation, a blood test for the prothrombin index is taken at least 3 times (once per trimester). If expectant mother significant deviations are diagnosed, it is necessary to do a coagulation test more often. The rate of prothrombin in the blood of women during pregnancy is lower than usual - from 70% to 120%.

Disturbances in the blood clotting mechanism of pregnant women are indicated by:

• Varicose veins on the limbs;
• Bleeding and noticeable bruising after minor injuries;
• Improper liver function;
• A long period of lack of results when trying to conceive;
• Conception through the IVF procedure;
• Multiple pregnancy;
• Fetal development lags behind norms;
• Drinking alcohol, smoking by the expectant mother;
• Long-term treatment with anticoagulants;
• Multiple miscarriages.

Since prothrombin according to Quick decreases during pregnancy, the INR index also decreases. Changes are especially noticeable in the second trimester of gestation. Until the 13th week, the coefficient should correspond to the norm: from 0.8 to 1.3. Then the indicator decreases:

1. From the 14th to the 20th week, the prothrombin index according to INR ranges from 0.55 to 1.1;
2. From the 21st to the 28th week, the indicator can decrease to 0.5, but cannot exceed 1.15;
3. From the 29th to the 35th week the result is 0.6 – 1.17;
4. From the 36th to the 42nd week the index is from 0.55 to 1.15.

In the case of pregnant women, the INR indexing method is preferred. The indicators are quite low, and the Quick method produces errors at critical values.

Normal operation various systems the human body occurs due to constant blood circulation through the vessels. The work of the heart allows the delivery of plasma containing formed elements - lymphocytes, platelets and red blood cells - to all tissues. Blood provides cellular respiration, removal of metabolic products, transportation nutrients etc. However, the amount of this biological fluid V human body relatively small and rarely exceeds 4-5 liters. To various injuries and the wounds were not fatal, there are special defense mechanisms, ensuring blood clotting. The most important component of this system are coagulation factors - protein compounds, one of which is prothrombin. To promptly identify the risk of bleeding or pathological thrombus formation, a hemostasiogram is performed. This is an analysis that allows you to determine the content of prothrombin in plasma.

Prothrombin is one of the glycoproteins, that is, proteins related to α-2-globulins. It is produced in hepatocytes - liver cells - and is responsible for the formation of the active enzyme thrombin.

Attention! Prothrombin is also called factor II of the prothrombin complex, a system that ensures normal blood clotting. It is formed by special plasma proteins, which are designated by Roman numerals from I to XIII.

Prothrombin is synthesized in the liver under the influence of a number of substances. One of the necessary components for the production of this protein is vitamin K. Its deficiency or excess leads to disruption of the normal formation of prothrombin.

If the human body functions normally, then the protein is in an inactive state. If bleeding develops under the influence internal system During hemostasis, prothrombin is converted to thrombin. As a result, a blood clot forms, which closes wound surface, preventing blood from flowing outside the vessel.

Lack of prothrombin is dangerous for the development heavy bleeding, including internal ones, and an excess of this glycoprotein causes blockage of arteries or veins with blood clots and leads to infarctions of the heart, brain and other organs.

Attention! Normally, the amount of prothrombin in human plasma should vary from 0.10 to 0.15 grams/liter. Indicators may differ slightly in people during illness or during gestation.

Analysis for prothrombin index

One of the most important studies of blood parameters is a clotting test. It makes it possible to identify severe pathologies in the patient’s body and determine their cause. Also, with the help of this diagnosis, it is possible to timely prevent hemorrhage or pathological thrombus formation.

Today, there are four tests that make it possible to determine the level of prothrombin in the blood:

1. Research on Kwik. Provides an opportunity to evaluate functional state glycoprotein and evaluate its activity. This way the presence of bleeding is detected.
2. Determination of prothrombin time. An analysis necessary to determine the patient's blood clotting period.
3. INR– international normalized ratio. This is a value that is equal to the ratio of a person’s prothrombin time to the normal protein value.
4. PTI– prothrombin index. Represents the ratio normal indicators prothrombin time to the data of the test sample.

The most frequently prescribed tests are directly the prothrombin index and Quick protein studies. In the first case, the indicators may vary depending on the type of reagents, but on average they are 95-100%.

Attention! Glycolipid molecules are destroyed very quickly. However, they are difficult to separate from other proteins, which significantly complicates diagnosis.

Quick protein analysis is a calculation of the level of active prothrombin in plasma as a percentage of normal. The acceptable amount varies from 70% to 120%. This indicator makes it possible to calculate the functional abilities of the prothrombin complex of blood in relation to all possible dilutions of the patient’s plasma. Based on the results obtained, a graphical curve is constructed taking into account information about the blood clotting period. The Quick study is considered the most informative when reduced rates prothrombin.

The prothrombin index is also indicated as a percentage. Normally it varies from 95 to 105%. In this case, the indicators of this analysis may coincide with the results of the Quick study if the patient’s health is in order. Otherwise, the data will vary greatly. It should also be noted that the index is significantly influenced by the quality of the reagents used in the analysis. Therefore, if poor results are obtained, it is recommended to repeat the diagnosis.

When calculating the index formula, it is necessary to take into account prothrombin time - an indicator of how many seconds the patient’s blood plasma clots after adding a reagent to it. The data obtained depend on the age of the patient. In an adult, prothrombin time should average 11-16 seconds.

If necessary, the international normalized ratio is used to control the results of the prothrombin index. This technique is necessary when treating a patient with anticoagulants - drugs that prevent blood clotting by lowering the level of prothrombin. This treatment is used in patients with thrombophlebitis, thrombosis large vessels, embolism, etc. Normally, the INR should not exceed 1.15.

Normal values ​​of prothrombin in a coagulogram

Norm of prothrombin in different patients age groups

Video - Blood test norms

Indications for the study

Testing for prothrombin index is important diagnostic procedure, allowing to identify pathologies of hematopoietic, cardiovascular and endocrine systems. Carrying out this study necessary for patients with the following indications:

1. The patient complains of increased bleeding due to injuries. Also, a coagulogram is necessary when a patient has long-lasting bleeding;
2. In humans, liver function is impaired, the activity of liver enzymes is reduced;
3. The patient is taking anticoagulants. Such a study is carried out throughout the entire treatment period to exclude the development of coagulopathies.
4. The patient pronounced deficiency vitamin K or diseases leading to its destruction.

Attention! Indications for the study are all of the above factors, as well as various deviations from the norm in biochemical or clinical analysis blood. In addition, it is necessary for women to determine the level of prothrombin in plasma during gestation to exclude placental abruption or bleeding during childbirth.

Norm of prothrombin during gestation

A coagulogram is a mandatory procedure when diagnosing the health of women during gestation. Prothrombin tests allow early stages determine the presence of conditions that are life-threatening for the patient and the fetus.

The glycoprotein index in pregnant women is usually slightly increased, that is, the rate of blood clotting increases. The shift in indicators is due to the formation of the vascular system between mother and child and the preparation of the patient’s body for childbirth. Increasing IPC is necessary to prevent extensive blood loss.

The normal prothrombin index in women during gestation ranges from 75 to 120%. Protein content is lower specified level indicates anemia, impaired production of coagulation factors, liver dysfunction, etc. Increased PTI is observed when hormonal imbalances and disorders of the cardiovascular system.

Attention! A decrease in the index to 60% or less is a sign of severe placental insufficiency or placental abruption. This condition requires immediate intervention. If such a pathology develops at the end of the third trimester, the question of a cesarean section is raised.

A decrease in PTI is also possible due to the incompatibility of the Rh factors of the patient and the embryo. As a result, the patient develops hemolytic shock during the destruction of red blood cells. To prevent such a complication, the specialist prescribes the woman regular diagnostics of the coagulation system and the administration of immunoglobulins to destroy dangerous antibodies.

Reasons for decreased prothrombin levels

A decrease in the prothrombin index is a sign of increased blood clotting. Such changes in the coagulogram are dangerous for the development of thrombosis. The need to start special anticoagulant therapy is indicated by a PTI rate of less than 75-80%.

This condition can develop under the influence of the following factors:

• excess production of fibrin, a protein necessary for the formation of a blood clot during blood clotting;
• hereditary factors and various genetic pathologies;
• use pharmacological drugs that help increase blood clotting: Ambien, Contrikal, Vikasol, etc.

The amount of prothrombin in plasma can be reduced by using anticoagulants: Neodicoumarin, Warfarin, Lepirudin, etc. In addition, patients with high PTI should adhere to special diet, which helps thin the blood. It should be understood that some types of food contribute to the formation of blood clots and can lead to the development of complications.

1. Cereals. Oatmeal dishes improve hemodynamics, reduce the risk of thrombosis and prevent excessive blood thickening.
2. Tomato juice. Preference should be given to a drink prepared independently from fresh vegetables. You need to drink juice 2-3 times a week, one glass, without adding salt or other spices.
3. Beet. It is the most useful product, allowing to reduce the level of prothrombin. It can be consumed both fresh and boiled. It is recommended to add flaxseed, sesame or olive oil to beet dishes.
4. Ginger root. It has a tonic effect on blood vessels, improves blood circulation and reduces its density. Ginger can be added to various drinks or used as a seasoning. Dried ginger root in sugar is also used as a dessert.
5. Fish fat . Available in capsule form, it has no pronounced taste or odor. Fish oil prevents the formation of blood clots in the vascular bed.
6. A pineapple. This fruit thins the blood and helps lower blood pressure.

With age, the prothrombin index in patients may decrease, which is due to hormonal changes. In people 50-55 years old, PTI is 75-100%. An increase in the amount of glycoprotein is also observed in women taking oral contraceptives. If the patient has any cardiovascular disease or liver dysfunction, it is recommended to replace the COC with vaginal suppositories or rings.

Reasons for increased prothrombin levels

An increase in the indicator may indicate the following diseases:

A reduced level of prothrombin poses a danger to human health, since even a minor injury to in this case may lead to extensive blood loss. To prevent such complications, the patient is prescribed the following drugs:

• Thrombin – natural component blood coagulation system;
• Vikasol is a synthetic analogue of vitamin K;
• Ambien is a drug that has an antifibrinolytic effect.

Attention! The doctor selects the dosage and type of the drug based on the results of the coagulogram and the patient’s health condition. In most cases, the patient must first stop the underlying disease that led to increased bleeding.

Video - Why is PTI prescribed?

Preparing for the study

Proper preparation of the patient for the test to determine PTI is extremely important, since otherwise the results may be unreliable. Eating fatty foods or alcohol, sleep disturbances - all this negatively affects blood counts. To obtain the most accurate data, the following recommendations should be followed:

1. Fence biological material performed on an empty stomach. In this case, food should be taken no later than eight hours before the procedure.
2. 2-3 days before the procedure, you need to exclude foods rich in lipids from the menu, as well as white cabbage, green tea and all types of legumes.
3. Avoid drinking strong drinks and alcohol-containing medications.
4. You should get a good night's sleep before the examination.

Prothrombin is a complex protein that takes an active part in the process of blood clotting. Today one of the most accurate diagnostic methods A way to determine the amount of this protein is to analyze the prothrombin index. It allows you to identify disturbances in the functioning of various body systems and prevent the development of thrombosis or pathological bleeding.