What is the norm of INR in the blood of women? What threatens the increased rate? Blood test for prothrombin index and INR - what is it? The norm is many in men after 60 years

The abbreviation INR does not mean much to a person who is not a medical professional. In order to understand what these mysterious letters mean, in this article we will introduce you to some features of the blood coagulation system. You will also find out: why the INR test analysis is prescribed, what are its normal indicators, to whom it is shown, how often it should be carried out and where it can be performed. So, what is the INR norm and what control methods are commonly used?

blood coagulation system

Normal blood density is ensured by the coordinated functioning of two systems: coagulation and anticoagulation. Its liquid state is regulated by anticoagulant mechanisms, and thrombus formation is regulated by coagulation. If the balance between them is disturbed, a person has an increased tendency to bleed or form blood clots (blood clots).

One of the most significant indicators of the coagulogram, reflecting the state of the coagulation system, is a complex protein - prothrombin. It is also called factor II of blood clotting. It is formed with the participation of vitamin K in the liver. It is by the indicators of this protein, which is a precursor of thrombin, that the doctor can assess the state of the coagulation system and the patient's tendency to bleed or thrombus.

Determination of the level of prothrombin in the blood can be carried out according to the following methods:

• PTT (prothrombin time);
• the level of prothrombin according to Quick;
• PTI (or prothrombin index);

In everyday clinical practice, doctors most often prescribe PTI or INR tests, since they most reliably reflect the state of the coagulation system.

What is INR and what is it for?

INR (or International Normalized Ratio) is an important laboratory test that reflects the ratio of a patient's prothrombin time to that of a healthy person. Such standardization of prothrombin indicators allowed doctors to bring different methods of studying the state of the blood coagulation system to a single, understandable and generally accepted indicator. This laboratory analysis gives stable results that are the same when the test is performed in different laboratories. The INR test has been approved by various international organizations and experts from the World Health Organization.

The introduction of the INR standard made it possible to effectively control the quality and safety of therapy for patients who are prescribed blood thinners (for example, Warfarin, Sinkumar, Finilin). are prescribed for a tendency to increased thrombosis observed in many pathologies: thromboembolic complications in coronary insufficiency, thrombosis, etc.

An increase in INR indicates a predisposition to bleeding, and the doctor decides to reduce the dosage of anticoagulants. With a decrease in the values ​​of this test, the patient increases the risk of blood clots. Such indicators indicate the low effectiveness of blood thinning drugs, and the doctor decides to increase the dose.

Norms of the INR test and decoding of the analysis

In a healthy person, normal INR test values ​​are in the range from 0.7 to 1.3 (usually 0.85-1.25), i.e. closer to 1. When taking Warfarin and other anticoagulants, normal INR values ​​\u200b\u200bshould be between 2.0 to 3.0. It is this value of the value that provides reliable prevention of thrombosis.

A change in INR values ​​in people who do not take blood thinners indicates pathological disorders occurring in the body.

An increase in INR above 1 indicates the possible presence of such pathologies:

• congenital pathologies of the coagulation system;
• lack of vitamin K in the body;
• liver pathology;
• improper absorption of fats in the intestine;
• side effects of anti-gout drugs, some antibiotics, steroids and anabolics.

First of all, such hypocoagulation is dangerous for the development of external or internal bleeding. INR values ​​above 6.0 are critical. Such jumps are especially dangerous in case of hypertension, inflammatory and ulcerative lesions of the gastrointestinal tract, pathologies of the vascular and urinary systems. In such cases, the patient is shown urgent hospitalization and treatment.

A decrease in INR below 1 indicates the possible presence of such pathologies or errors:

• increase or decrease in hematocrit;
• increased levels of antithrombin III;
• side effects of glucocorticoids, contraceptives, diuretics or anticonvulsants;
• blood sampling for analysis was carried out from a catheter located in the central vein;
• during the analysis, the blood plasma was at +4 °C for a longer time than specified in the regulations.

Changes in INR values ​​in people taking Warfarin or other anticoagulants indicate the need to adjust the dosage of these drugs.

Hypocoagulation (decrease in coagulability and increase in INR) can lead to the development of bleeding, and in such cases, the dose of drugs is reduced. External bleeding in such cases can be provoked even by minimal mechanical trauma, and internal bleeding (abdominal, uterine, gastric, etc.) can be caused by any diseases and physiological processes (for example, menstruation).

Hypercoagulable patients have an increased risk of thrombosis and an increased risk of developing severe complications (PE and thrombosis). In such cases, the dosage of anticoagulants is increased.

Indications for the appointment of INR

The appointment of a blood test for INR is carried out according to certain indications. The norm indicators of this test differ depending on the underlying disease of the patient.

Indications:

1. Preoperative examination of patients. The norm is closer to 1 (from 0.7 to 1.3, usually 0.85-1.25).
2. Taking blood thinners (such as warfarin). The norm is 2.0-3.0.
3. TELA therapy. The norm is 2.0-3.0.
4. Condition after aortic valve replacement with a mechanical implant. The norm is 2.0-3.0.
5. Condition after mitral valve replacement with a mechanical implant. The norm is 2.5-3.5.
6. Preventive treatment of pulmonary embolism in heart disease. The norm is 2.0-3.0.
7. Prophylactic treatment of deep vein thrombosis after surgery. The norm is 2.0-3.0.

INR analysis for patients taking blood thinning drugs is carried out at certain intervals, which are set individually by the doctor. At the beginning of the disease, when the patient is in the hospital, such tests are performed daily. Further, the patient is recommended to perform INR control once a week and, if the test indicators are stable, then the frequency of tests can be reduced to 1 time in 2-3 weeks.

The reason for the appointment of an extraordinary test may be such changes in the life of the patient or symptoms of hypocoagulation:

• prolonged cold or other illness;
• change in the scheme of concomitant therapy;
• lifestyle or diet changes;
• abrupt climate change;
• unmotivated nosebleeds;
• bleeding gums;
• causeless appearance of hematomas;
• blood in urine:
• prolonged and heavy menstruation in women;
• streaks of blood in sputum or vomit;
• blood in the stool (or tarry stool);
• prolonged bleeding from cuts;
• inexplicable seals, pain and swelling in the joints while taking a drug to thin the blood.

Where can I donate blood to determine INR?

You can conduct an INR test in the following ways:

It is most convenient to perform the INR test at home, because the patient does not have to visit the clinic often, donate venous blood (it is most often used in laboratories to perform this analysis) and spend their time waiting in lines. This test requires fresh blood from a finger. A painless skin puncture is performed using a special automatic device (scarifier). Test strips are inserted into the measuring device, which is equipped with a display, onto which a blood sample is applied. After a short period of time, the INR indicator appears on the display. Using such a portable device is easy, simple and very convenient.

An INR analysis according to WHO recommendations should be prescribed for all treatments that require constant monitoring of blood coagulation. It most accurately reflects the state of the human blood coagulation system. This test has been approved by all leading experts in anticoagulant and antithrombotic therapy monitoring.

Blood clotting under the influence of external factors (primarily air) - very important defensive reaction, which saves a person's life countless times throughout his life.

This process is very complex and multifaceted, its essence lies in conversion of soluble fibrinogen protein to insoluble fibrin, between the threads of which blood cells get stuck. This forms a blood clot that closes the wound opening and prevents blood from leaving the bloodstream.

Numerous enzymes, salt ions and other substances take part in this process, many of which are contained in platelets - special shaped elements that are responsible for blood clotting.

As you can see, without blood clotting, a person could die from the loss of this liquid tissue, even in the case of a small injury. But when the blood clots too easily, it's also harmful because clots can form inside the bloodstream. Blood clots block blood vessels, resulting in heart attacks and strokes.

INR is a value that is calculated based on the prothrombin time (PTT), that is, the time of blood clotting. Prothrombin is a substance of a protein nature, which, when the vessels are damaged, turns into another protein, thrombin. Thrombin, in turn, converts fibrinogen to fibrin.

When testing for prothrombin time, a special blood clotting compound is added to the blood ( thromboplastin-calcium mixture), and measure the time it takes for the blood to clot. Usually it takes about 11-15 seconds.

The thromboplastin used in the mixture may have different activities, and therefore it is incorrect to use absolute indicators. In order to somehow unify the results of the analysis, a single international standard was adopted, which was called the international normalized ratio, abbreviated INR. Thanks to unification, specialists from any country can correctly understand the results of the analysis and draw appropriate conclusions.

The international normal ratio is calculated by the formula INR = (prothrombosis time of this patient divided by the Normal mean prothrombosis time) and multiplied by international sensitivity index(This indicator characterizes the sensitivity of a particular thromboplastin).

After 40

INR norm does not change with age. It remains unchanged in a healthy person throughout life, and ranges from 0.8 to 1.2 units.

After the age of 40, many people develop diseases associated with the occurrence of blood clots, the rate of blood clotting most often increases, and clotting time, respectively, falls.

After 50

INR values ​​in most people decrease even more, and at the same time, the risk of thrombosis increases. Normal indicators remain at this age in the region of one.

After 60

In old age, the likelihood of diseases associated with the formation of blood clots increases twice every ten years. Irreversible changes occur in the body, and increased blood clotting is one such change. Healthy people at this age are rare, and have the same INR as in youth - about one.

However, diseases associated with decreased rate of blood clotting, usually do not depend on age, and appear at any age, or accompany a person throughout a person's life.

Diseases

A change in INR can cause a number of serious complications and diseases:

• A high rate of blood clotting is associated with the risk of diseases such as thrombosis, heart attack, stroke etc. With a high clotting rate, the INR is low.
• With a low clotting rate and, accordingly, a high INR, heavy bleeding occurs. In addition, poor clotting may be associated with diseases such as liver disease, malignant tumors, hemophilia, and the like.
• INR is of great importance in preparation for surgery, since it is very important that the blood clot, and the bleeding that occurs when the tissue is cut can stop. Accordingly, with unsatisfactory INR indicators, the operation, if possible, is transferred and drugs are prescribed that correct blood clotting in the right direction.

Conclusion

Thus, INR stands for international normalized ratio, and is a unit of measurement for the rate of blood clotting. To determine this rate, a reagent called thromboplastin, and may have different activity from different manufacturers and in different laboratories.

Recalculation of the blood clotting rate to INR allows you to take into account this difference and get a result that will be the same for thromboplastin of any activity.

There are many diseases associated with high or low INR and, accordingly, increased or decreased blood clotting. So, with low coagulability, bleeding occurs, including internal ones, and if the blood coagulation rate is too high, blood clots form directly in the bloodstream, which leads to strokes or heart attacks.

An analysis for INR allows you to detect the onset of the disease in time and prevent it.

There are many types of blood tests in the world. Some of them are aimed at identifying viruses and bacteria in the body, others at identifying missing substances. The INR blood test (International Normalized Ratio) is an integral part of the life of those people who, due to their health, are forced to monitor the consistency of their blood, namely, this analysis helps to determine the presence of clots and seals in the circulatory system.

INR - is not an actual value, and is calculated by mathematical equations. The value of PT (prothrombin time) is taken as the basis, the normal value of which is considered to be 11-16 seconds and the thromboplastin sensitivity index (MIC), which is an active developing reagent.

The result of the INR readings can be represented as a mathematical formula (INR = PV MIC). In most cases, such an analysis is prescribed for people taking anticoagulants who need constant and timely monitoring of blood clotting. As a result of such an analysis and the correct calculation, specialists have the opportunity to get an accurate idea of ​​​​the level of plasma in the blood, excluding errors and any external factors. Regardless of which laboratory the blood test was performed in, the results will be valid in medical institutions around the world and will be identical when deciphered. Such a blood test will allow specialists to select the required amount of anticoagulants and fully control the treatment process.

Analysis procedure

Such an examination is carried out every two to three weeks for people who are taking anticoagulant drugs (for example, warfarin). In some cases, the INR analysis has to be taken more often, it depends on the stage of treatment and the severity of the disease. Patients with an already established dosage of drugs, a blood test is performed monthly. Blood sampling for INR does not differ from blood sampling for biochemical analysis. Venous blood required.

Before taking the test, you must follow the same rules as when taking a general blood test:

• you can take an INR analysis only on an empty stomach;
• the day before, exclude strongly fried, spicy, salty or sweet foods from the diet;
• refrain from drinking alcoholic beverages.

INR analysis for both women and men is carried out in a special research laboratory, in compliance with all blood sampling standards.

Interpretation of INR data

The basic rule when interpreting INR data is that the higher the test result, the thinner the blood condition.

• The normal value of the INR means that the anticoagulants are selected in the correct dosage, the treatment is carried out effectively and in the right direction.
• An increased value indicates the presence of an overdose of indirect anticoagulants, there is a possibility of opening bleeding, dose adjustment is required.
• A reduced value indicates that the dosage of the drugs was chosen incorrectly, and does not bring proper treatment. As a result, there is a risk of the formation of a blood clot, due to the too thick consistency of the blood.

Doctors distinguish the following indicators when deciphering the analysis:

The norm of indications is valid for both women and men. Going beyond the upper or lower limit of indications is extremely dangerous for the body, and in some cases can lead to death. A reading below normal means that the blood in the body is too thin, which can lead to difficult-to-stop bleeding. In this condition, the rate of anticoagulant drugs recommended for use is increased.

If the norm of INR readings has gone beyond the border, an adjustment in the dose of drugs is required. With a hanged indication of INR, blood clotting decreases, which can lead to the discovery of internal bleeding.

According to experts, the norm of indications above 1, 3, without taking special stabilizing drugs is dangerous to health, and can lead to a pre-infarction state, or even a hemorrhagic stroke, due to internal hemorrhage. When the indicator exceeds the norm by 2 times, a person needs immediate hospitalization, since there is a risk of hemorrhage of any direction. Timely decoding accurately shows the condition of a sick person, and helps to accurately determine the dosage of stabilizing drugs. Due to the timely prevention of thrombosis in the arterial system, it is possible to avoid taking expensive drugs and a rather long treatment.

Blood test for INR and PTI (prothrombin index) - what is it? The study allows you to obtain data on its coagulation properties, that is, the ability to coagulate. Its increase, as well as its decrease, can lead to serious consequences. These analyzes are very important in clinical practice for the diagnosis of various diseases, for monitoring the ongoing treatment with anticoagulants.

What is INR and PTI?

Elderly people and those suffering from cardiovascular diseases had to not only hear about INR and PTI blood tests, but also take them more than once as prescribed by a doctor. Why do doctors pay so much attention to these tests and oblige their patients to take them regularly?

The fact is that both tests are indicators of the state of the blood, or rather, its viscosity, the ability to coagulate. More liquid blood circulates well through the vessels, thicker blood complicates blood circulation, promotes the formation of blood clots.

The doctor observing the patient must have information about the state of his blood in order to choose the right treatment. This applies mainly to diseases of the cardiovascular system, vascular atherosclerosis, which today are the main "killers" on the planet.

The abbreviation INR stands for "International Normalized Ratio", that is, unified international standards for research and blood parameters have been adopted. In whatever country the patient is located, when providing assistance to him, they will be guided by uniform criteria.

PTI analysis is a prothrombin index that reflects the patient's blood coagulation as a percentage of a control blood sample, which is taken as 100%. This is a simpler analysis than the INR and may be variable depending on the type of laboratory reagents.

Determination of the prothrombin index is necessary to calculate the INR, there is an inverse relationship between them: the higher the PTI, the lower the INR value and vice versa.

Why measure INR and PTI

In medical practice, INR analysis is very important for controlling blood clotting in patients taking tableted (indirect) anticoagulants, such as warfarin, phenylin, tromexane, and others. They are often prescribed in conditions where there is a threat of thrombosis: heart rhythm disturbances, blood clotting, severe vascular atherosclerosis, thrombophlebitis, increased prothrombin.

Treatment with anticoagulants should always be carried out under the control of coagulation., because their insufficient dose can only "spur" thrombosis, and excessive intake, on the contrary, reduce clotting and lead to the development of bleeding.

It is the INR analysis that reflects the most objective picture of blood clotting, regardless of the time of day, food or liquid intake.

An analysis of the prothrombin index (PTI) reveals the very fact of a decrease or increase in blood clotting. It is always prescribed before operations, childbirth, blood transfusion and other procedures, it is prescribed for patients with cardiovascular pathology, the elderly. Deviation of PTI from the norm is an indication for examination of the patient to determine the cause of the violations.

Technique and frequency of blood sampling

Blood for INR analysis is prescribed by the doctor treating anticoagulants, usually 2 times a month, if necessary, and more often. If the treatment is adjusted, and the patient's condition is stable, INR control is carried out once a month.

The analysis is taken in the morning on an empty stomach, the day before you can not drink alcohol, you need to limit physical activity. Blood for analysis is taken from a vein in a laboratory as prescribed by a doctor in the usual way, as for other studies.

Today, the problem of determining the INR is greatly simplified, it can be controlled even at home by purchasing a portable analyzer (CoaguChek XS). It allows you to get information about the state of the blood much more often without visiting the clinic and puncturing the veins. All you need is a small drop of capillary blood from a finger, and the analysis itself is carried out by testing on paper strips, which are stored for up to 1.5 years.

The device carries out electrochemical analysis, is quite accurate and complies with international WHO recommendations.

An analysis for PTI is also taken on an empty stomach in the laboratory, subject to the same rules. Blood is taken from a vein or from a finger (capillary), while its indicators will be slightly different.

Result interpretation

When deciphering the results of a blood test for INR, its age norms are taken into account, which are presented in the table.

INR norms

The norm of INR in the blood in women and men does not differ. INR values ​​can deviate from the norm both in one direction and in the other.

Increase in INR

An increase in the value of the analysis indicates a decrease in blood clotting, the reasons may be the following:

• Prolonged or excessive use of oral anticoagulants.
• Deficiency of prothrombin protein.
• Vitamin K deficiency.
• Diseases of the liver.
• Diseases of the kidneys.
• Blood diseases (leukemia, erythropathies).
• Polycythemia.
• Long-term use of hormonal drugs.

An increase in the INR indicates the likelihood of developing a hemorrhagic syndrome (bleeding), and requires the appointment of hemostatics: vitamin K, dicynone and other drugs.

You will be interested in:

Decreased INR

A decrease in the indicator is evidence of hypercoagulability in the blood, that is, an increase in its coagulability. This may be in the following cases:

• With circulatory failure.
• With liver failure.
• In patients with hypothyroidism, myxedema.
• With obesity.
• During acute inflammatory diseases with fever.
• After drinking alcohol.

A decrease in the indicator, on the contrary, indicates blood hypercoagulation and the risk of developing thrombosis. In these cases, anticoagulants are prescribed with regular monitoring of a blood test for clotting.

PTI norms

When evaluating a blood test for the prothrombin index (PTI), the patient's age is also taken into account, normal age indicators are presented in the table (the norm for women and men does not differ):

The analysis takes into account the increase or decrease in the prothrombin index.

PTI deviations

An increase in PTI should alert: this indicates the likelihood of blood clots in the patient, which means that a heart attack or stroke may develop. Also, an increase is characteristic of oncological diseases, polycythemia (erythrocyte disease), and bleeding.

A decrease in the prothrombin index may be due to a lack of vitamin K, the prothrombin protein, which occurs in liver diseases, where it is synthesized. There may also be a hereditary deficiency of clotting factors.

Indications for analysis for INR and PTI

The purpose of the INR test is actually to determine the time of formation of a blood clot, which reflects the clotting properties of the blood at a given moment. In medical practice, it is used to monitor treatment with indirect (tablet) anticoagulants, most often warfarin. This is necessary to maintain a normal level of blood clotting in various diseases (cardiovascular, oncological, endocrine, and others).

A study on PTI is prescribed in the following cases:

• When undergoing a complete examination of the patient;
• In the presence of vascular pathology (atherosclerosis, heart attack, stroke, arteritis, thrombophlebitis, varicose veins);
• With thrombosis and thromboembolism;
• With liver diseases with a violation of its function;
• Before invasive medical manipulations: blood transfusion, surgery, organ transplantation;
• Before childbirth;
• With bleeding;
• With DIC syndrome (severe pathology - disseminated intravascular coagulation).

Both analyzes are also carried out during regular examinations of patients in the dispensary group with various diseases in which a violation of the coagulation system is possible.

In the article, we examined what an analysis for INR and prothrombin index (PTI) is, as well as how much it should be normal.

INR or international normalized attitude- coagulation index, part of a set of tests for diagnosing bleeding and thrombosis, as well as the correctness of treatment with warfarin. Included in the group.

The INR is a laboratory test that evaluates the extrinsic pathway for blood clotting.

The process of curtailing and stopping bleeding consists of three parallel events:

• spasm of the damaged vessel
• thrombus formation from
• a complex of reactions in blood plasma - a coagulation cascade - according to the domino principle, activation of one factor leads to further activation of another until a stable thrombus is formed

Only the full interaction of all participants in the process will lead to an effective stop of bleeding. For the last stage, several dozen clotting factors are needed; for convenience, they are denoted by letters in the order of discovery.

In the coagulation cascade, two pathways are distinguished - external and internal. The internal path is triggered by “activated” platelets from inside the vessel, and the external path is triggered by fragments of damaged cell membranes from damaged tissue - tissue factor.

Of course, such a division is rather arbitrary, but acceptable in practice, it allows, by looking at the test results, to evaluate the process of blood coagulation.

INR is the main indicator of the external coagulation pathway. The most important factors involved are:

1. II - prothrombin
2. VII - proconvertin
3. X - Stuart-Prower factor

In the early 1980s, the World Health Organization (WHO) recommended the use of INR instead of IPT due to greater sensitivity and specificity, as well as less dependence on reagents, which allows comparison of results from different laboratories.

INR shows how much the blood clotting has changed compared to the standard. For example, an INR of 1.7 means that blood clots 1.7 times slower.

Method principle

1. blood is added to a test tube with sodium citrate (or other anticoagulant); the anticoagulant binds ions, and without calcium, the blood does not clot; so, in the test tube remains uncoagulated blood

2. since blood cells contain clotting factors, they are removed from the blood by centrifugation

3. add to the test tube:

• calcium in excess - calcium is necessary for coagulation
• thromboplastin (tissue factor, coagulation factor III) - triggers clotting

→ in the resulting solution there is plasma without platelets, calcium, an activator of the external coagulation pathway

4. note the time of clot formation, the result - (PTV) - i.e. the time required for the formation of prothrombin

INR is calculated by the formula

INR = (Patient PTT / Control PTT) raised to MIC

MIC - International Thromboplastin Sensitivity Index (ISI - International Sensitivity Index), is 1-2. MIC is the tissue factor activity in a given batch of reagent and is listed by the manufacturer on each package. The activity of tissue factor can fluctuate, so it is difficult to compare the results of PTT analysis from different laboratories, but the INR levels this difference.

INR evaluates only part of the blood coagulation process, only a study of several indicators will give a complete picture.

If the vessel wall is damaged, bleeding will begin. The coagulation system is activated, the vessel spasms and narrows, the number of platelets and inactive coagulation factors increases, which quickly turn into an active form and form insoluble fibrin strands from the soluble fibrinogen protein.

To achieve the ultimate goal of coagulation - to stop bleeding and restore blood flow in the vessel, all components of the process are needed in appropriate proportions - both in terms of volume and activity.

If coagulation factors are more active, then there is a high risk of thrombosis with minimal damage, if anticoagulants are stronger, bleeding with any injury.

Deficiency or excess of one or another factor may not appear at all or be fatal.

Indications

• simultaneously with other tests that allow you to evaluate the process of blood clotting -, prothrombin time,
• in case of bleeding
• regular monitoring of the correctness of treatment with warfarin only
• with thrombosis of the vessels of any organ - deep vein thrombosis, kidney infarction,
• for the diagnosis of congenital and acquired deficiency of blood coagulation factors - II, VII, IX and X
• long-term severe liver disease
• diagnosis of DIC and control of its treatment

Several groups of drugs are used to treat and prevent the formation of blood clots. Coumarins(warfarin, acenocoumarol) - disrupt the metabolism of vitamin K in the liver and thus disrupt the synthesis of blood coagulation factors II, VII, IX and X. The main problem of warfarin treatment is the high individuality of the dose, it must be selected based on the results of INR.

At the beginning of treatment with warfarin, INR control is carried out on day 3-4, then 2-3 times a week until the target is reached; then check every 6-8 weeks.

Norm

• INR norm for adults - 0.8-1.2

With an INR above 5, the risk of bleeding is increased, with an INR below 0.5, the risk of thrombosis.

The norm of INR in the treatment of oral anticoagulants (warfarin) is 2-3.

Some conditions (for example, a prosthetic heart valve) have "their" INR norms.

The INR norm is the same for all laboratories.

What influences the result?

• reduce INR - barbiturates, hormonal contraceptives, vitamin K, fever, thyroid hormone preparations, allopurinol, anabolic steroids, androgens, antiarrhythmic drugs, some antibiotics, H2 receptor antagonists (used for and), antidiabetic drugs, alcohol, green tea , soybeans, beef and pork liver, green vegetables - spinach, various types of cabbage, lettuce, broccoli
• pradaxa, clexane, xarelto - do not change the level of INR

Decryption

Reasons for the increase

Increased INR results show how many times the clotting of this blood is higher than the standard.

• treatment with oral anticoagulants (warfarin)
• liver disease with a violation of its synthetic function -
• hereditary factor X deficiency - Stuart-Prower disease
• hereditary factor V deficiency - parahemophilia, Ovren's disease
• hemorrhagic diathesis of newborns
• circulating in the blood
• massive blood transfusion

Reasons for the decline

Decreased INR indicates a tendency to thromboembolism.

Data

• INR can be measured at home with rapid tests
• INR is not recommended in preoperative evaluation of patients (unless previously treated with anticoagulants)
• a decrease in PTT is accompanied by an increase in INR - the coagulation time is lengthened and the risk of bleeding increases, an increase in PTT leads to a decrease in INR - the coagulation time is reduced, the risk of thrombosis
• individual target INR- INR indicator, which must be achieved and adhered to by the patient with his disease
• to quickly reduce INR (with an overdose of warfarin), use a vitamin K preparation - kanavit or frozen plasma (which contains the necessary clotting factors)

INR - international normalized ratio was last modified: November 16th, 2017 by Maria Bodyan