From Big Medical Encyclopedia

KOAGULOGRAMMA (Latin coagulatio coagulation, a condensation + grech, gramma the line, the image) — the graphic representation or digital expression of results of a research of system of a hemostasis made by means of a complex of methods, allowing to judge its functional state, and also coagulative and vascular and platelet mechanisms of a hemostasis.

Different types To. apply for: 1) differential diagnosis hemorrhagic diathesis (see); 2) identifications of thrombogenic potential of blood, i.e. the increased ability of blood to intravascular coagulation and a thrombogenesis; 3) express diagnoses of the acute disorders of a hemostasis arising suddenly against the background of normal functioning of system of a hemostasis, napr, during operations or childbirth, and leading to intravascular fibrillation; 4) control of anticoagulating, fibrinolitic and anti-aggregation therapy.

A set of the methods used for studying in To., it is various and is defined by character, genesis and clinic of a disease, type of manifestations of bleeding at hemorrhagic diathesis and type of an intravascular blood coagulation. To. can be approximate and developed.

Approximate To. includes the methods allowing to judge about coagulative and platelet and vascular hemostasis (see), i.e. about funkts, a condition of system of a hemostasis in general. At differential diagnosis of the hemorrhagic diathesis caused by disturbance of a platelet and vascular hemostasis with coagulative diathesis in approximate To. definition enters blood clotting time (see), bleeding time (see), quantities thrombocytes (see), retractions of a blood clot (see. Retraction ), fibrinolitic activity (see. Fibrinolysis ) and resistance of a wall of vessels.

Developed To. includes: the analytical methods allowing to judge a condition of the internal mechanism, activation prothrombin (see) — methods of definition of consumption of a prothrombin and generation of thromboplastin, and also the external mechanism of activation of a prothrombin — methods of definition prothrombin time (see) that allows to judge the final stage of process of a blood coagulation; methods of definition of thrombin time (see. Thrombin ), concentration fibrinogen (see), a factor of XIII and anticoagulating activities of blood (see. Coagulant system of blood ). Besides, developed To. includes the analytical methods allowing to define deficit, change of properties or funkts, activities of thrombocytes and to differentiate hemorrhagic diathesis depending on the inborn or acquired deficit of separate factors of system of a blood coagulation.

At express diagnosis of acute disorders of a hemostasis, the disseminated intravascular blood coagulation for development of tactics of treatment differentiate real hypercoagulation, potential hypercoagulation, hypocoagulation and hypocoagulation with a hyper fibrinolysis. For this purpose investigate a blood clotting time, a blood clotting time at addition to it of fibrinogen, thrombin time, thrombin time at addition to blood of fibrinogen, a prothrombin time. The answer is received in 4 — 5 min. after the beginning of a research. During the performing anticoagulating, fibrinolitic and anti-aggregation therapy by additional control methods of a condition of system of a hemostasis are definition of a prothrombin time during the performing anticoagulating therapy anticoagulants of indirect action, at administration of heparin — definition of a blood clotting time and content in blood of heparin, at fibrinolitic therapy — definition of components of fibrinolitic system and a blood clotting time, at anti-aggregation therapy — definition of aggregation of thrombocytes. At subacute and hron, forms of an intravascular blood coagulation, in addition to the specified researches, there are additional — methods of determination of quantity of thrombocytes, fibrinogen, fibrin-monomers, products of degradation of fibrinogen, physiological anticoagulants.

A number of the methods of a research entering in To., it is insensitive. Such methods reveal only considerable disturbances of a hemostasis (e.g., a blood clotting time, a calcium clotting time of plasma), are insufficiently standardized and informative. The figures received by means of such methods have considerable fluctuations even at healthy people. The blood clotting time can be normal at latent and easy forms of hemophilia and increases only at decrease in concentration of factors of VIII and IX are 3 — 4% lower than average sizes. Indicators of tests of consumption of a prothrombin and generation of thromboplastin are in limits of norm at decrease in concentration of factors of VIII, IX and XI to 10% normal amounts therefore these tests are unsuitable for identification of easy and latent forms of hemophilia.

Advantages at a research K. have the standardized methods: kaolinic time, a kaolin — a kefalinovy blood clotting time, quantitative definitions of separate factors.

Bibliography: Baluda V. P., Chekalina S. I. and Black V. V. Express diagnosis of disturbances in system of a hemostasis at ostrovoznikayushchy bleedings, Laborat, business, No. 5, page 273, 1976; The Research of system of a hemostasis in clinic, sost. 3. S. Barkagan, Barnaul, 1975; Koagulogramma, under the editorship of V. A. Germanov, Kuibyshev, 1975; Kudryashovb. A. Biological problems of regulation of liquid state of blood and its coagulation, M., 1975, bibliogr.; Lyusovv.A., Belousov Yu. B. and Bokarev I. N. Treatment of thromboses and hemorrhages in clinic of internal diseases, M., 1976, bibliogr.; Prevention of tromboembolic episodes in surgery and obstetrics, under the editorship of V. P. Valuda, Tomsk, 1976; Rabi To. The localized and scattered intravascular coagulation, the lane with fr., M., 1974, bibliogr.; Austen D.E.G. Rhyme s I. L. A laboratory manual of blood coagulation, Oxford, 1975; B e r k a r-da B., Akokan G. Derman U. Self-coagulogram, Thrombos. Diathes. hae-morrh. (Stuttg.), v. 13, p. 297, 1965; Human blood coagulation, haemostasis and thrombosis, ed. by R. Biggs, Oxford, 1976; Sirridge M. S. Laboratory evalution of hemostasis, Philadelphia, 1974.

V. P. Baluda.