Протромбиновый индекс, норма которого равна 95-105%, is one of the indicators characterizing the blood coagulation system. Blood coagulation is a very complex process, with the participation of a whole cascade of special proteins called coagulation factors. Activation of this process is possible on two paths - internal and external.
Именно протромбиновый индекс характеризует activation of coagulation along the external pathway. It consists in the following: when tissue integrity is violated (wounded), so-called tissue thromboplastin, a special protein contained in all tissues of the body, is secreted. It triggers a cascade reaction into which other clotting factors (V, VII, and X, II, I) enter, sequentially activating each other. Eventually, a blood clot forms, and the bleeding stops.
What is prothrombin index says
Clotting factors are formed in the liver.Of these, II, V, X are vitamin-K dependent. With a deficiency of this vitamin their synthesis is disrupted. Accordingly, there are violations of hemostasis. Knowing prothrombin index, the norm of which is known, the doctor can:
How is the prothrombin index determined?
The prothrombin index in the capillaryor in venous blood. In the second case, the blood on an empty stomach is taken into a test tube with an anticoagulant in a ratio of 9: 1. As an anticoagulant, sodium citrate is used. In the laboratory, the blood is centrifuged. The resulting plasma is used in the determination of prothrombin time (PT). The norm of PV is in the range of 12 to 20 seconds, depending on the activity of thromboplastin, which is used during the reaction in this laboratory.
Knowing PV of the patient, it is possible to calculate PI, that isprothrombin index, the norm of which in different laboratories may also be slightly different. It is equal to the ratio of PV of a healthy person to the patient's IV, multiplied by 100:
PI = PV zdor./PV is sick. X 100 (norm 95-105%)
Clinical significance of PI
With increasing clotting of PV, or prothrombin,the norm of which is from 12 to 20 seconds, is shortened, and the PI increases. It can be during pregnancy, with massive trauma, when a lot of tissue thromboplastin enters the bloodstream.
Conversely, the PV increases, and the PI decreases withdecrease in clotting, for example, in case of congenital insufficiency of coagulation factors, with severe liver diseases, with a lack of vitamin K (it can occur with cholestasis, dysbacteriosis, intestinal dysfunction). Reduced PI with low fibrinogen or its functional inferiority, with the syndrome of ICE, in the presence of substances that inhibit coagulation.
What is INR
Treatment with indirect anticoagulantsdecreases prothrombin index. Its norm can be different in each laboratory. Therefore, in order to be able to compare the results of the analyzes obtained in different laboratories, a standardized test was introduced, such as MNO. This is the calculated figure. It is determined on the basis of the ratio of prothrombin time of the patient, the normal value of PV and the degree of the index of sensitivity of thromboplastin (MIC).
MNO = (MF b-th / MF norm) to the degree of MIC
In a healthy person, INR is in the range 0, 8-1.2.
This indicator is used in the control ofeffectiveness of anticoagulants. When treating with anticoagulants, when coagulability is reduced, (for example, after heart surgery), INR should be increased to 2-3. With increased clotting, the INR decreases. The ratio between PI and INR is such that when the PI decreases, the INR increases.
