If soe increased, the operation can be canceled. Blood test - ESR increased: causes and treatment

For almost a hundred years in the practice of doctors, a diagnostic method has been used - an analysis for the ESR (or ROE) indicator. The decoding of the abbreviation is not known to everyone, it raises logical questions - what are the indications for conducting a study, which means a high ESR indicator on the analysis form, what processes reflects a deviation from the norm.

A blood test allows you to find out the erythrocyte sedimentation rate. This method has become the main diagnostic method used in the early stages of the search for pathologies. A high ESR in a blood test is the basis for additional research. The result of the analysis does not indicate a disease that develops in a person. The increase in indicators is facilitated by the individual characteristics of the subject's organism, his age and gender.

How is the research carried out, its purpose?

The increased erythrocyte sedimentation rate is determined by the results of the analysis. For carrying out, a blood sample is taken from a finger, then an anticoagulant is added. The sample is placed in a capillary - a thin graduated tube. It fits into a tripod. After a certain period of time, red blood cells settle, blood plasma remains on top - a yellowish liquid, between them a "layer" of platelets and leukocytes is formed. The result of the analysis is determined from the level of the formed plasma per hour, recorded as mm / hour (millimeters per hour).

For clinical diagnostics, devices and apparatus are used that allow you to quickly determine an increase in ESR. Traditional research methods are also used.

The method of analysis is often used, the accuracy of the result is high. The use of Vintrob and Panchenkov's methods is less common in diagnostics.

Many factors can be the reason for the increase in the indicator. Conducting the analysis together with other diagnostic procedures allows you to achieve the goals:

• give an initial assessment of the patient's health;
• the result contributes to the selection and conduct of additional research;
• track the effectiveness of treatment at any stage, correct, predict the effectiveness, the possible outcome of the disease.

A blood test will help to find out how much ESR is increased

What are the ESR indicators - the norm?

Analyzes allow you to determine the ESR in the blood, to evaluate the indicators - the values \u200b\u200bwhen they are normal or to note an increase. The age category of the patient, gender, health characteristics, the presence of certain diseases affect the increase in the indicator obtained as a result of the study.

In children under one year old, the formation and development of the immune system, organs and body systems occurs, which also determines the ESR indicators.

1. In the first days of life in babies, the values \u200b\u200bof indicators from 0 to 2 mm / h indicate the norm.
2. Until the age of one year, doctors consider the range from 2 to 10 mm / h to be optimal.
3. In preschoolers, the erythrocyte sedimentation rate is increased to values \u200b\u200bin the range of 5-11 mm / h.
4. The norm in late childhood corresponds to the results of 4-12 mm / h.

Blood in women and men has different cell content, erythrocytes are deposited at different rates. The normal value for the stronger sex is in the range from 2 to 12 mm / h. A woman's norm is determined by a speed of 3 mm / h, ESR 20 is the limit value.

In people, the normal value of the indicator, determined in the course of clinical studies, changes with age.

After 50 years, it can be significantly increased, ESR 50 is not critical for people of this age category and older. Therefore, high rates after reaching the retirement age are the norm, and significantly differ from the indicators identified in previous years, for example: at 30 years old. This is due to the fact that age-related changes occur in the erythrocyte.

Decrease and increase the rate of subsidence

The value of the analysis for diagnosis

High ESR in the blood test is associated with physiological processes in the human body. An increase in the erythrocyte sedimentation rate in adults is facilitated by conditions associated with:

• acute form of appendicitis;
• possible myocardial infarction;
• the development of angina pectoris;
• with a pregnancy developing outside the uterus.

At the first suspicions of these pathological conditions, especially dangerous for human life, it is required to conduct a blood test, to check the erythrocyte sedimentation rate values. This method allows you to carry out emergency measures of a therapeutic or surgical orientation on time, which will save the patient from health problems, sometimes from death.

A high level of ESR is associated with the use of antibiotics during treatment. This side effect from taking drugs of this group is temporary, after a while there is a decrease to the norm of the indicator.

Deviation of indicators in women after 50 years

Patient grade

In medical practice, there are four degrees of deviations in an adult patient associated with increased ESR in the blood. Each degree reflects, so much the indicator exceeds the norm:

1. First degree - there is a slight excess of the norm, the value of other blood parameters remains at the normal level.
2. The second degree - situations when the normal threshold is exceeded and ranges from 15 to 29 units. With such indicators, the development of a slight inflammatory process is characteristic, which is observed during the period of seasonal colds, the correct treatment of which is associated with a decrease in increased indicators. It can develop with normal leukocytes.
3. At the third degree, ESR corresponds to indicators of more than thirty units. With such an increase, speaking about significant inflammatory foci, the development of processes of death of organ tissues - extremely dangerous processes that require the close attention of doctors and high-quality treatment.
4. An increased ESR level in a patient, which is 48-60 or more, is the fourth degree of deviation, the highest limit. The acceleration of the ESR reaction in this sense indicates dangerous, life-threatening pathologies of the patient.

Speed \u200b\u200bstandards for people over 60 years old

For what diseases is increased ESR

Why does ESR increase? What diseases or other causes lead to these rates? What do the numbers in them mean? Such questions are asked by patients to the attending physician.

Immediately and unequivocally, the reason for the high values \u200b\u200brecorded on the form cannot be announced by any specialist. Only additional diagnostic methods help to determine what causes of increased ESR may be in a particular patient.

The main reasons leading to an increased number in the blood test are the presence of diseases.

If the ESR is higher than the norm, this means the development of one or several diseases:

• infections of a bacterial, viral or fungal nature - their progression triggers processes in which ESR is increased, the reaction rate increases, because leukocytes in the blood are increased. The reasons for the high test result can be influenza, bronchitis and pneumonia, viral hepatitis, tuberculosis.
• neoplasms of various nature (malignant and benign) - the development of tumors is associated with a significant increase in the erythrocyte sedimentation rate, the level of leukocytes does not increase, the number of leukocytes will increase only with the development of certain types of neoplasms;
• analysis, when the ESR indicator is increased, helps to determine diseases of the rheumatological type: arthritis, arthrosis, rheumatism, changes in the connective tissues of a diffuse nature, lupus erythematosus and others;
• high rates are accompanied by diseases of the urinary tract, kidney - urolithiasis, pyelonephritis, hydronephrosis;
• blood diseases.

One of the main reasons that increases ESR, a process that accelerates the reaction, is the poisoning of the body with harmful substances, toxins of various origins. With it, processes associated with a change in the qualitative composition of the blood occur, in which the number of leukocytes changes, its density increases, which causes increased ESR values \u200b\u200bdue to the fact that the erythrocyte sedimentation rate is increased.

Organ diseases can cause accelerated ESR

Other causes of increased ESR

Sometimes the reason for which the syndrome of accelerated ESR is observed is not associated with a pathological disorder of body functions. An increase in indicators is observed with normal health, caused by natural processes and an individual reaction to them. Patients are worried about an increased result for no reason and do not know what to do to keep the rate of subsidence normal.

A high ESR of a false nature, an increase in the syndrome of an increase in the erythrocyte sedimentation rate can be provided by:

• taking hormonal drugs;
• an unbalanced diet containing foods low in iron;
• persistent effect on the body of allergens;
• an excess of vitamins in the body, especially A;
• constant stress, psychological environment deviating from normal.

Individual characteristics of people contribute to the accelerated process observed during erythrocyte sedimentation, as evidenced by an increase in ESR in them. Such a level, which rises for no particular reason, is studied; correction is not required. Minor fluctuations in blood counts associated with the level of leukocytes, an accelerated reaction are observed depending on the time of day.

How to reduce an increased erythrocyte sedimentation rate: foods to reduce rates

Under what conditions is accelerated ESR observed in women?

Features of female nature - pregnancy, breastfeeding, changes in hormonal levels in different periods of life increase the rate of erythrocyte sedimentation. What causes such processes, what does their presence mean, why is the value of indicators increased?

For women, before decoding the test results, the doctor makes a survey about the presence of "critical" days, taking hormonal contraceptives, changing nutrition due to diet, and possible pregnancy.

The listed reasons can change the blood content, increase the rate of leukocytes, contribute to a more rapid erythrocyte sedimentation, change the saturation of the blood with leukocytes.

If the result of ESR in the blood of women is increased, such an analysis result indicates pregnancy, or diseases associated with the acceleration of red blood cells. For example - an increased ESR of 45 during pregnancy is the norm, should not cause concern in the expectant mother. Its maximum value during this period reaches 55-70 units.

There are ESR norms for pregnant women, depending on the fullness of the body. Indicators in the first half of pregnancy for thin women will correspond to normal if their value is 32-33, 32-38, 42-46. For obese pregnant women, the ESR indicator 51-52, 55-57 is dangerous and exceeds the norm.

At present, medicine has ample opportunities, however, for a separate type of diagnosis, research methods developed almost a century ago have not yet lost their relevance. ESR (erythrocyte sedimentation rate), previously referred to as ROE (erythrocyte sedimentation reaction), has been known since 1918. Methods for measuring it have been defined since 1926 (Westergren) and 1935 by Winthrop (or Winthrob) and are still in use today. A change in ESR (ESR) helps to suspect a pathological process at its very beginning, to identify the cause and to start early treatment. The indicator is extremely important for assessing the health of patients. Within the framework of the article, we will consider situations when people are diagnosed with increased ESR.

ESR - what is it?

The erythrocyte sedimentation rate is really a measurement of the movement of erythrocytes under certain conditions, calculated in millimeters per hour. For the study, a small amount of the patient's blood is needed - the count is included in the general analysis. It is estimated by the size of the plasma layer (the main blood component) remaining on top of the measuring vessel. For the reliability of the results, it is necessary to create conditions under which only the force of gravity (gravity) will affect the erythrocytes. It is also necessary to prevent blood clotting. In the laboratory, this is done thanks to anticoagulants.

The erythrocyte sedimentation process can be divided into 3 stages:

1. Slow settling;
2. Acceleration of sedimentation (due to the formation of erythrocyte columns formed in the process of gluing individual erythrocyte cells);
3. Deceleration of subsidence and complete stop of the process.

Most often, it is the first phase that matters, but in some cases it is necessary to evaluate the result even one day after blood sampling. This is done already at the second and third stages.

Why is the parameter value increasing?

The level of ESR cannot directly indicate the pathogenic process, since the reasons for the increase in ESR are varied and are not a specific sign of the disease. In addition, the indicator does not always change in the course of the disease. There are several physiological processes in which the ROE increases. Why, then, is the analysis still widely used in medicine? The fact is that a change in ROE is observed at the slightest pathology at the very beginning of its manifestation. This allows you to take emergency measures to normalize the condition, before the disease seriously undermines human health. In addition, the analysis is very informative in assessing the body's response to:

• Medical treatment performed (use of antibiotics);
• If you suspect myocardial infarction;
• Appendicitis in the acute phase;
• Angina pectoris;
• Ectopic pregnancy.

Pathological increase in the indicator

Increased ESR in the blood is observed in the following groups of diseases:
Infectious pathologies, more often of a bacterial nature. An increase in ESR may indicate an acute process or a chronic course of the disease.
Inflammatory processes, including purulent and septic lesions. For any localization of diseases, a blood test will reveal an increase in ESR
Connective tissue diseases. ROE is high with SCS - systemic lupus erythematosus, vasculitis, rheumatoid arthritis, systemic scleroderma and other similar diseases
Inflammation localized in the intestines in ulcerative colitis, Crohn's disease
Malignant formations. The highest indicator rises with myeloma, leukemia, lymphoma (the analysis determines an increase in ESR in bone marrow pathology - immature red blood cells that are unable to perform their functions enter the bloodstream) or stage 4 cancer (with metastases). ROE measurement helps to assess the effectiveness of treatment for Hodgkin's disease (cancer of the lymph nodes)
Diseases accompanied by tissue necrotization (myocardial infarction, stroke, tuberculosis). About a week after tissue damage, the ROE indicator rises to the maximum.
Blood diseases: anemia, anisocytosis, hemoglobinopathy
Diseases and pathologies, accompanied by an increase in blood viscosity. For example, profuse blood loss, intestinal obstruction, prolonged vomiting, diarrhea, postoperative recovery
Diseases of the biliary tract and liver
Diseases of metabolic processes and the endocrine system (cystic fibrosis, obesity, diabetes mellitus, thyrotoxicosis and others)
Injuries, extensive skin damage, burns
Poisoning (food, bacteria waste, chemicals, etc.)

Raising above 100 mm / h

The indicator exceeds the level of 100 m / h in acute infectious processes:

• ARVI;
• Sinusitis;
• Flu;
• Pneumonia;
• Tuberculosis;
• Bronchitis;
• Cystitis;
• Pyelonephritis;
• Viral hepatitis;
• Fungal infections;
• Malignant formations.

A significant increase in the norm does not occur at once, the ESR grows for 2-3 days before reaching the level of 100 mm / h.

When an increase in ESR is not a pathology

Do not sound the alarm if a blood test shows an increase in the rate of red blood cell sedimentation. Why? It is important to know that the result must be assessed over time (compare with earlier blood tests) and take into account some factors that can increase the significance of the results. In addition, the syndrome of accelerated erythrocyte sedimentation can be a hereditary feature.

ESR is always increased:

• During menstrual bleeding in women;
• When pregnancy occurs (the indicator may exceed the norm by 2 or even 3 times - the syndrome persists for some time after childbirth, before returning to normal);
• When women use oral contraceptives (oral contraceptive pills);
• In the morning. There are known fluctuations in ESR values \u200b\u200bduring the day (in the morning it is higher than in the afternoon or in the evening and at night);
• With chronic inflammation (even if it is a banal runny nose), the presence of acne, boil, splinters, etc., the syndrome of increased ESR can be diagnosed;
• Some time after the completion of treatment for a disease that can cause an increase in the indicator (often the syndrome persists for several weeks or even months);
• After eating spicy and fatty foods;
• In stressful situations just before the test or the day before;
• For allergies;
• Some medications can cause this blood reaction;
• With a lack of vitamins with food.

Increased ESR level in a child

In children, the ESR indicator can increase for the same reasons as in adults, however, the list above can be supplemented by the following factors:

1. When breastfeeding (neglecting the mother's diet can cause accelerated red blood cell sedimentation syndrome);
2. Helminthiasis;
3. Teething period (the syndrome persists for some time before and after it);
4. Fear of testing.

Methods for determining results

There are 3 methods for calculating ESR manually:

1. According to Westergren. For the study, blood is taken from a vein, mixed in a certain proportion with sodium citrate. The measurement is carried out according to the distance of the tripod: from the upper border of the liquid to the border of red blood cells that have settled in 1 hour;
2. According to Winthrob (Winthrop). The blood is mixed with an anticoagulant and placed in a tube with divisions. With a high sedimentation rate of red blood cells (more than 60 mm / h), the inner cavity of the tube quickly clogs up, this can distort the results;
3. According to Panchenkov. For the study, blood is needed from the capillaries (taken from a finger), 4 parts of it are combined with a part of sodium citrate and placed in a capillary, graduated to 100 divisions.

It should be noted that analyzes carried out according to different methods cannot be compared with each other. In the case of an increased indicator, the first method of calculation turns out to be the most informative and accurate.

Currently, the laboratories are equipped with special devices for automated ESR calculation. Why is automatic counting widespread? This option is the most effective because it excludes the human factor.

When making a diagnosis, it is necessary to evaluate the blood test in the complex, in particular, great importance is attached to leukocytes. With normal leukocytes, an increase in ROE may indicate residual effects after a previous illness; at reduced - on the viral nature of the pathology; and at elevated - for bacterial.

If a person doubts the correctness of the blood tests carried out, then you can always double-check the result in a paid clinic. Currently, there is a technique that determines the level of CRP - C-reactive protein, it excludes the influence of external factors and indicates the response of the human body to the disease. Why hasn't it become widespread? The study is a very costly undertaking, it is impossible for the country's budget to introduce it into all state medical institutions, but in European countries the ESR measurement was almost completely replaced by the determination of the PSA.

Oncological diseases are characterized by the presence of malignant neoplasms in various organs. They are formed as a result of the degeneration of healthy tissue cells into tumor cells, after which they begin to rapidly divide.

An important indicator is ESR (erythrocyte sedimentation rate), it reflects the presence of various diseases, including oncological, and inflammatory processes.

What is the ESR indicator in the blood for oncology? This question is asked by most of the patients who have a significant excess of the norm.

The importance of ESR

To date, scientists have identified several types of cancer. These include cancer, sarcoma, leukemia, and lymphoma. But the reasons why they develop have not been established.

Experts have identified a number of factors that significantly increase the likelihood of developing cancer, for example, regular alcohol consumption, hormonal imbalances, smoking, unfavorable environmental conditions, exposure to toxic substances.

Oncological diseases may not appear for several years. Often, it is possible to determine the presence of cancers using laboratory tests. The reasons for going to the doctor are lack of appetite, chronic fatigue, seals on the skin.

To establish the disease, a general blood test is prescribed. ESR in oncology is the main indicator, but a set of diagnostic measures is used to accurately establish the disease.

Ultrasound, MRI, CT and other examinations are prescribed to confirm the diagnosis. Indicates various pathological changes in the body, decreased or increased level of ESR in the blood.

Does the rate of red cell sedimentation increase in cancer? This question is asked by many patients who have a sharp change in ESR indicators.

Most often, there is an increase in the erythrocyte sedimentation rate in oncology. Based on the results of a general blood test, the doctor makes a preliminary diagnosis... That is why ESR is one of the important indicators in the detection and treatment of cancerous tumors.

ESR norms

The settling time of blood cells can vary depending on various pathological and physiological factors. For men and women, ESR values \u200b\u200bare different. The indicator also changes during the day, the maximum values \u200b\u200bare noted in the daytime.

ESR indicators within normal limits differ depending on gender and age. For women under the age of 20, the value should not exceed 18 mm / hour, but not less than 2 mm / hour. For women under 55 years of age, rates from 2 to 20 mm / hour are the norm. At an older age, the indicator should not exceed 23 mm / hour.

During pregnancy, ESR from the second trimester gradually begins to increase to 55 mm / hour. With a woman's well-being, this value is not critical. After the birth of the child, the ESR time gradually decreases and returns to normal after three weeks.

ESR values \u200b\u200bfor men are slightly different from those for female patients. At the age of 20 years, ESR should not be more than 12 mm / h. Up to 55 years of age, the level may slightly increase to 14 mm / hour. After 55, the settling time of red cells is 19 mm / hour.

Some sources indicate the ESR limits from 2 to 10 mm / h.

ESR values \u200b\u200bdiffer at different times of the day. A slight excess of the indicators in all cases requires re-passing the analysis. The norm in oncology depends on the stage of spread of cancer cells, the presence of metastases, the form of oncology, but most often it exceeds the rates in healthy people.

Study for ESR

A study to determine the ESR is carried out in a laboratory. The analysis can be done in two ways.

Panchenkov's method

For research, blood is taken from a finger (capillary). The procedure is carried out using a Panchenkov capillary and a concave glass, on which a certain amount of anticoagulant is applied.

After collection, the blood is applied to glass in order for it to lose the ability to clot. Then it is drawn into the capillary. The result is determined within an hour by the height of the translucent liquid.

To date, it is not a common way to establish ESR, since there is a more accurate and informative one.

Westergren's method

The analysis is carried out in a test tube that has a scale of 200 divisions and a graduation for each millimeter. Blood is drawn not from a finger, but from a vein. The biological material is mixed with an anticoagulant in a test tube. The sedimentation rate of red cells is established within an hour.

After the ESR value is established, additional diagnostic methods are assigned to confirm the preliminary diagnosis.

Preparation for analyzes

But in order for the indicators to be the most accurate, you should properly prepare for the delivery of the analysis. Before the procedure, a number of recommendations should be followed:

1. Blood is donated on an empty stomach or after a light breakfast. It is necessary to give up strong tea and coffee, as these drinks cause vasospasm, which complicates the process of taking biological material.
2. On the eve of the diet, it is necessary to completely exclude alcoholic beverages, fatty foods, nicotine and drugs, under the influence of which blood clotting decreases.
3. It is best to take tests in one laboratory. This is necessary in order for the indicators to be reliable and to track the dynamics of treatment.

In addition, donating blood to establish the erythrocyte sedimentation rate is not recommended after X-ray studies.

With a slight increase or decrease in the norm, a second study is required, since this is often the result of improper preparation for the test.

ESR indicators for oncological diseases

How much does ESR increase in oncology? With the formation of cancerous tumors, a sharp (up to 70-80 mm / hour) increase in indicators is noted.

But a similar reaction of the body can also occur in the presence of an inflammatory process and other diseases. Thus, exceeding the norm is not a direct sign by which cancer is established.

When the ESR value changes, the patient is sent for a complete examination in order to establish the true cause of the increase or decrease in indicators.

The reasons for exceeding erythrocyte sedimentation rates are tumors:

• breasts;
• cervix;
• ovaries;
• bone marrow;
• lymph nodes.

In rare cases, other forms of cancer can be identified, which also require careful examination. ESR in lung cancer can be characterized by an increase in normal values, but if the morphological type of leukocytes changes, the disease may not manifest itself for a long time.

The erythrocyte sedimentation time is the main indicator of the presence of various changes that occur in the body. But with any change in the normal values, additional diagnostics are assigned.

In some cases, ESR may decrease in cancer. The cause may be an increase in the number of leukocytes or bile salts during breastfeeding. When the development of cancer cells provokes an increase in the number of leukocytes, the pathology gives two completely opposite effects that cancel each other out. Consequently, the increase in ESR in the presence of cancer occurs more slowly.

Should you panic?

The time of erythrocyte sedimentation in the blood is influenced by many different factors. The main one is the ratio of protein substances and blood plasma... With a high content of globulins or fibrinogen, ESR values \u200b\u200bincrease. In the case of a predominance of albumin (fine proteins), the sedimentation rate decreases.

It is not worth panicking at an increased or decreased value of the sedimentation rate, since not in all cases this is a signal that cancer cells are forming in the body.

For an accurate diagnosis, it is also necessary to take into account changes in other indicators, for example, the number of leukocytes, white blood cells, protein substances. Only after a detailed study of the analysis result, the doctor makes a preliminary diagnosis. To confirm it, a set of additional diagnostic studies is assigned.

Exceeding the norm can also become evidence of development:

• Anemia.
• Various diseases of the kidneys and adrenal glands.
• Infectious diseases.
• Allergic reactions.

The erythrocyte sedimentation rate can increase:

• when taking medications of a certain group that affect the rate of blood clotting;
• during menstruation in women;
• during a strict diet.

ESR is an important indicator in the diagnosis of oncological diseases, but it is not the main indicator in the diagnosis. Changes in indicators do not always indicate the occurrence of cancer. This can be due to a number of other reasons and requires careful examination.

The erythrocyte sedimentation rate (ESR) is a non-specific laboratory blood index reflecting the ratio of plasma protein fractions.

A change in the results of this test up or down from the norm is an indirect sign of a pathological or inflammatory process in the human body.

Another name for the indicator is "erythrocyte sedimentation reaction" or ROE. The subsidence reaction occurs in the blood, which is deprived of the ability to fold, under the influence of the force of gravity.

The essence of blood testing for ESR is that erythrocytes are the heaviest elements in blood plasma. If you set a test tube with blood vertically for some time, it will be divided into fractions - a thick brown red blood cell sediment at the bottom, and a translucent blood plasma with the rest of the blood elements at the top. This separation occurs under the influence of gravity.

Erythrocytes have a peculiarity - under certain conditions, they "stick" together, forming complexes of cells. Since their mass is much greater than the mass of individual erythrocytes, they settle to the bottom of the test tube faster. With an inflammatory process in the body, the rate of unification of erythrocytes increases, or, conversely, decreases. Respectively, the ESR increases or decreases.

The accuracy of blood testing depends on the following factors:

Correct preparation for the analysis;

Qualifications of the laboratory assistant conducting the research;

The quality of the reagents used.

If all the requirements are met, you can be sure of the objectivity of the research result.

Indications for the determination of ESR are control over the appearance and intensity of the inflammatory process in various diseases and in their prevention. Deviations from the norm indicate the need for a biochemical blood test to clarify the level of certain proteins. Based on a single ESR test, it is impossible to make a specific diagnosis.

The analysis takes 5 to 10 minutes. Before donating blood for ESR determination, do not eat for 4 hours. This completes the preparation for donating blood.

Capillary blood sampling sequence:

Rub the third or fourth finger of the left hand with alcohol.

A shallow incision (2-3 mm) is made on the fingertip with a special tool.

Remove the protruding drop of blood with a sterile napkin.

Biomaterial is collected.

Disinfect the puncture site.

A cotton swab moistened with ether is applied to the pad of the finger, and asked to press the finger to the palm of the hand to stop bleeding as soon as possible.

The sequence of venous blood sampling:

The patient's forearm is tied with a rubber band.

The puncture site is disinfected with alcohol, a needle is inserted into the vein of the elbow.

Collect the required amount of blood in a test tube.

Remove the needle from the vein.

The puncture site is disinfected with cotton wool and alcohol.

The arm is bent at the elbow until the bleeding stops.

The blood taken for analysis is examined to determine ESR.

The test tube, which contains the biomaterial with the anticoagulant, is placed in an upright position. After some time, the blood will be divided into fractions - red blood cells will appear below, transparent plasma with a yellowish tint will appear above.

The erythrocyte sedimentation rate is the distance covered by them in 1 hour.

ESR depends on the plasma density, its viscosity and the radius of erythrocytes. The calculation formula is rather complicated.

Procedure for determining ESR according to Panchenkov:

Blood from a finger or vein is placed in a “capillary” (a special glass tube).

Then it is placed on a glass slide, then sent back to the "capillary".

The tube is placed in Panchenkov's tripod.

An hour later, the result is recorded - the value of the plasma column following the erythrocytes (mm / hour).

The method of such a study of ESR is adopted in Russia and in the countries of the post-Soviet space.

ESR analysis methods

There are two methods for laboratory testing of blood for ESR. They have a common feature - before the study, the blood is mixed with an anticoagulant so that the blood does not clot. The methods differ in the type of the studied biomaterial and in the accuracy of the results obtained.

For research using this method, capillary blood taken from the patient's finger is used. ESR is analyzed using a Panchenkov capillary, which is a thin glass tube with 100 divisions applied to it.

The blood is mixed with an anticoagulant on a special glass in a ratio of 1: 4. After that, the biomaterial will no longer coagulate, it is placed in a capillary. After an hour, the height of the column of blood plasma, separated from the erythrocytes, is measured. The unit of measurement is millimeter per hour (mm / hour).

Westergren's method

A study using this method is an international standard for measuring ESR. To carry it out, a more accurate scale of 200 divisions, graduated in millimeters, is used.

Venous blood is mixed in a test tube with an anticoagulant, ESR is measured after an hour. The units are the same - mm / hour.

The gender and age of the subjects affects the ESR indicators, taken as the norm.

In healthy newborns - 1-2 mm / hour. Reasons for deviations from the standard indicators - acidosis, hypercholesterolemia, high hematocrit;

in children 1-6 months - 12-17 mm / hour;

in children of preschool age - 1-8 mm / hour (equal to that of adult men);

For men - no more than 1-10 mm / hour;

In women - 2-15 mm / hour, these values \u200b\u200bdiffer depending on the level of androgen, from 4 months of pregnancy, the soybean increases, reaching 55 mm / hour, after childbirth, it returns to normal in 3 weeks. The reason for the increase in soe is an increased level of plasma volume in pregnant women, globulins.

An increase in indicators does not always indicate pathology, the reason for this may be:

The use of contraceptives, high molecular weight dextrans;

Fasting, use of diets, lack of fluid, leading to the breakdown of tissue proteins. A recent meal has a similar effect, so blood is taken on an empty stomach for ESR determination.

Exercise-induced metabolic increase.

Change in ESR depending on age and gender

The acceleration of ESR occurs due to an increase in the level of globulins and fibrinogen. Such a shift in the protein content indicates necrosis, malignant transformation of tissues, inflammation and destruction of connective tissue, and impaired immunity. A prolonged increase in ESR over 40 mm / h requires other hematological studies to determine the cause of the pathology.

Table of ESR rates in women by age

Indicators found in 95% of healthy people are considered the norm in medicine. Since a blood test for ESR is a non-specific study, its indicators are used in diagnostics in conjunction with other tests.

According to the standards of Russian medicine, the border of the norm for women is 2-15 mm / hour, abroad - 0-20 mm / hour.

The values \u200b\u200bof the norm for a woman fluctuate depending on changes in her body.

Indications for a blood test for ESR in women:

Lack of appetite,

Neck pain, shoulder pain, headache,

Pain in the pelvic area,

Unreasonable weight loss.

ESR rate in pregnant women, depending on completeness

ESR in pregnant women depends directly on the level of hemoglobin.

ESR rate in blood in children

ESR above normal - what does it mean?

The main reasons that accelerate the rate of erythrocyte sedimentation are changes in the composition of the blood and its physicochemical parameters. For the implementation of erythrocyte sedimentation, the plasma proteins are agglomerins.

The reasons for the increase in ESR:

Infectious diseases that provoke inflammatory processes - syphilis, tuberculosis, rheumatism, blood poisoning. Based on the results of ESR, a conclusion is made about the stage of the inflammatory process, and the effectiveness of treatment is monitored. With bacterial infections, ESR values \u200b\u200bare higher than with diseases caused by viruses.

Endocrine diseases - thyrotoxicosis,.

Rheumatoid arthritis.

Pathologies of the liver, intestines, pancreas, kidneys.

Intoxication with lead, arsenic.

Malignant lesions.

Hematological pathologies - anemia, myeloma, lymphogranulomatosis.

Injuries, fractures, conditions after surgery.

High cholesterol.

Side effects of drugs (morphine, Dextran, Methyldorf, vitamin B).

The dynamics of changes in ESR can vary depending on the stage of the disease:

In the initial stage of tuberculosis, the level of ESR does not deviate from the norm, but increases with the development of the disease and with complications.

Insufficient fibrinogen levels;

Reactive erythrocytosis;

Chronic circulatory failure;

In men, ESR is almost impossible to notice below normal. In addition, such an indicator is not of great importance for diagnosis. Symptoms of a decrease in ESR are hyperthermia, fever. They can be precursors of an infectious disease or inflammatory process, or signs of a change in hematological characteristics.

To normalize the indicators of laboratory testing of ESR, you should find the reason for such changes. Most likely, you will have to undergo a course of treatment prescribed by a doctor, additional laboratory and instrumental studies. An accurately diagnosed and optimal therapy for the disease will help bring ESR indicators back to normal. Adults will need 2-4 weeks for this, children - up to one and a half months.

With iron deficiency anemia, the ESR reaction will return to normal if a sufficient amount of foods containing iron and protein are consumed. If the reason for the deviation from the norm was a passion for diets, fasting, or such physiological conditions as pregnancy, breastfeeding, menstruation, ESR will return to normal after the normalization of health.

With an increased level of ESR, natural physiological reasons should first be excluded: old age in women and men, menstruation, pregnancy, the postpartum period in women.

Attention! 5% of the inhabitants of the Earth have a congenital feature - their ROE indices differ from the norm without any reason and pathological processes.

If there are no physiological reasons, there are the following reasons for the increase in ESR:

• Inflammatory process,

  Malignant tumors

  Kidney disease

  Acute or chronic infections

  Myocardial infarction,

  Burns, injuries,

  Condition after surgery.

In addition, the erythrocyte sedimentation reaction can be affected by therapy with estrogens, glucocorticosteroids.

The reasons for the decrease in the erythrocyte sedimentation rate:

Violation of water-salt metabolism;

Progressive myodystrophy;

1st and 2nd trimester of pregnancy;

Taking corticosteroids;

Vegetarian diet;

Starvation.

In the event of a deviation from the norm, you should consult a doctor to find out the reason for this state of health.

Editorial opinion

The ESR indicator depends not only on the physiological processes in the human body, but also on the psychological component. Both negative and positive emotions affect the ESR indicators. Severe stress, a nervous breakdown will definitely change the erythrocyte sedimentation reaction. Therefore, on the day of donating blood and on the eve of it, it is advisable to normalize your psycho-emotional state.

About the doctor: 2010 to 2016 Practitioner of the therapeutic hospital of the central medical-sanitary unit No. 21, city of elektrostal. Since 2016 she has been working in the diagnostic center No. 3.