Thrombolysis test evaluates the ability to clot and stop bleeding

This phenomenon of hemostasis can cause blood clots, so it should be done under the control and regulation of the body. To determine whether the patient's coagulation status is working properly and to find abnormalities in hemostasis, coagulation factor tests should be performed.

The process of blood clotting, hemostasis in humans is a defense to help the body stop bleeding, prevent blood from flowing after an injury occurs in our blood vessels, but it can have consequences. embolize blood vessels. Some of the clotting factors in this process will be diluted and eliminated by the liver, but there will be inhibitors that inactivate as well as degrade the activated clotting factors. These inhibitors are produced in the liver, except in the case of thrombomodulin from endothelial cells.
This process of blood clotting, hemostasis works based on a combination of 3 factors: the vessel wall, blood cells such as platelets, and plasma proteins that work through enzyme reactions. Blood clotting, hemostasis is regulated by the body through neurological and humoral factors. The balance between the two processes, coagulation and anticoagulation, helps the body to cope with bleeding and blood vessel blockage.

Vasoconstriction: vascular damage occurs, the control of nerve and humoral factors will cause the vessel to constrict, reduce the vessel diameter and thereby reduce the outflow of blood, creating favorable conditions for the constriction. platelet adhesion under the endothelium. Endothelial cells: play a very important role in anticoagulation, creating a balance between plasma coagulation factors and hemostatic activators. Subendothelial organization: These subendothelial organizations will be exposed for platelet adhesion when the blood vessel wall is damaged, thereby activating the coagulation process and hemostasis. Platelets: are one of the extremely important components in hemostasis thanks to their functions such as adhesion, release and aggregation. When the vessel wall is damaged, platelets will stick to the subendothelial layer, releasing substances such as ADP, serotonin... to activate the clotting process. The substances that platelets release will make the platelets stick together, amplifying to create a larger platelet mass to fill in the damaged areas of the vessel wall. Plasma clotting factors: these clotting factors are glycoproteins with different functions and are divided into 3 groups: exposure factors, vitamin K-dependent factors, and fibrinogen groups. important role in hemostasis.

3.1 Initial hemostasis exploratory tests Initial hemostatic tests include:
Counting blood platelets Counting bleeding time by Duke or Ivy method Clotting test to monitor contraction blood clots in the body. The ligature sign is used to detect low platelet count or abnormal platelet function, abnormal blood vessel structure. Stop platelet aggregation to assess platelet function. Quantification of vWF factor is to determine the quantity and quality of vWF factor to serve the diagnosis of Willebrand as a hereditary hemostasis disorder. 3.2 Coagulation probe assay Coagulation time Prothrombin time (PT) represents exogenous coagulation activity. Activated partial thromboplastin time (APTT) represents endogenous coagulation activity including APTT and APTTr Thrombin time (TT) represents the overall coagulation activity and fibrin formation rate, including TT and TTr Reptilase time Determination of Fibrinogen Quantification of clotting factors Quantification of natural anticoagulants AT-III, Protein C (PC), Protein S (PS). 3.3 What is fibrinogenesis? Because coagulation is a process where the damaged area of ​​the blood vessel is covered by a clot containing platelet cells and fibrin. The coagulation process consists of an initial hemostasis phase where platelets form the primary platelet plug, and at the same time a secondary hemostasis process, plasma coagulation factors that produce fibrin or fibrin. is fibrinogen for consolidation with the established platelet plug.
The fibrinolytic tests in the investigation of hemostasis include:
Von kaulla test to determine the time to dissolve blood clots, from the measurement of fibrinolytic activity:
Normal: clot thawed after 3 hours. Acute fibrinolysis: from 0 to 15 minutes. Subacute fibrinolysis: 15 to 30 minutes. Moderate fibrinolysis: 30 to 45 minutes. Latent fibrinolysis: 45 to 60 minutes. Quantification of fibrin and fibrinogen degradation substances (FDP, D-Dimer). Normal limits are as follows:
FDP < 5000 ng/L. D-Dimer > 500 ng/L. Quantifying factors involved in fibrinolysis include plasminogen, a2- antiplasmin, PAI-1. The normal range is as follows:
Plasma plasminogen from 80% to 120%. a2- antiplasmin from 80% to 120%. PAI-1 < 10 AU/mL. Among the clotting factor tests, the fibrinogenesis test is considered one of the important tests to contribute to the investigation of the blood clotting and hemostasis process of the body. From there, it will diagnose as well as promptly treat diseases related to blood coagulation and hemostasis.

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