Is there a problem with thrombin time 21.4

The clotting time of 21.4 seconds is mildly prolonged and may indicate abnormal coagulation function. The prolongation of thrombin time is mainly related to factors such as decreased fibrinogen, heparin anticoagulant therapy, abnormal fibrinogen, early DIC, and primary fibrinolysis.

1. Decreased fibrinogen:

Fibrinogen levels below 1.5g/L can lead to prolonged thrombin time. Commonly seen in wasting diseases such as cirrhosis, severe malnutrition, or congenital hypoalbuminemia. Diagnosis can be confirmed through plasma fibrinogen testing, and mild reduction can be improved through dietary supplementation with high-quality protein.

2. Anticoagulation effect of heparin:

The therapeutic dose of heparin directly inhibits thrombin activity, prolonging the thrombin time to 2-3 times the reference value. If the patient is receiving heparin treatment, this result is considered an expected response. It is necessary to adjust the dosage of anticoagulants based on indicators such as APTT to avoid the risk of bleeding.

3. Abnormal Fibrinogenemia:

Hereditary abnormal fibrinogen caused by abnormal fibrinogen structure in patients affects the formation of fibrin oligomers. These patients usually have a tendency towards bleeding or thrombosis, and need to be diagnosed through genetic testing and fibrinogen functional testing.

4. Early manifestations of DIC:

In the early stage of disseminated intravascular coagulation, thrombin time may be slightly prolonged accompanied by thrombocytopenia. Dynamic observation of changes in D-dimer, FDP and other indicators is necessary to be alert to the subsequent occurrence of multiple microthrombi and consumptive coagulation disease.

5. Primary fibrinolysis:

Excessive activation of the fibrinolytic system leads to accelerated degradation of fibrinogen, which is seen in severe trauma, malignant tumors, etc. The typical manifestation is prolonged thrombin time accompanied by a significant increase in FDP, which requires treatment with anti fibrinolytic drugs such as tranexamic acid.

It is recommended to complete supplementary examinations such as fibrinogen quantification and D-dimer testing when prolonged thrombin time is detected. Avoid strenuous exercise and trauma in daily life, and increase intake of foods rich in vitamin K such as spinach and animal liver. If symptoms such as skin bruising and gum bleeding occur simultaneously, immediate medical attention should be sought to investigate severe coagulation dysfunction. Regular check ups of coagulation function are of great significance for monitoring changes in the condition, especially for patients receiving anticoagulant therapy or those with chronic liver disease.