What does a blood test for ESR show: norm and deviations. The erythrocyte sedimentation rate is increased - what does it mean, how to quickly reduce the erythrocyte erythrocyte sedimentation rate in the blood - what is it

The erythrocyte sedimentation rate helps to effectively and timely diagnose various inflammations and pathologies in the body. This is part of a general blood test. Consider for what reasons the speed is higher or lower than normal. How is ESR analyzed? What measures should be taken to normalize the speed?

What is ESR in blood

Red blood cells are the heaviest elements in blood plasma. If the test tube with blood is placed vertically, it will divide into two parts - a brown erythrocyte sediment, translucent plasma. Erythrocytes stick together, becoming heavier than the test mass.

In a blood test, the rate of sediment formation per hour is estimated in millimeters. Deceleration, acceleration in an adult means the development of an illness. The change in speed shows the response to a particular treatment. The study of ESR as part of a general blood test is certainly carried out in adults and children.

Normal and pathological indicators of ESR

The ESR rate depends on age, gender. The table shows what the ESR should be in children and healthy adults by age.

After 50 years in the blood of men, the norm is ESR 15 mm / h.

When ESR is above normal

A high erythrocyte sedimentation rate (ESR) does not always mean a serious illness. This can be observed as a result of fasting, a rigid diet, and lack of water. The same effect is caused by the intake of fatty foods before taking blood for analysis. The rapid precipitation of elements in the sediment will cause recent physical activity, the use of contraceptives. Among the physiological reasons, allergic reactions are also distinguished, improper antiallergenic therapy, the period of menstruation, carrying a baby and the postpartum three weeks in women.

ESR increase above 100 mm / h

An excess of ESR of more than 100 mm / hour from normal means that the composition of the blood has changed, its physicochemical indicators. This is possible due to the development of inflammatory reactions, rheumatological, oncological diseases, and before the manifestation of other symptoms. With infectious processes, the ESR grows within 2-3 days, not at once. The reason for the erythrocyte sedimentation rate over 100 mm / h can be:

• bronchitis;
• ARVI;
• sinusitis;
• cystitis;
• flu;
• pyelonephritis;
• viral hepatitis;
• tuberculosis;
• pneumonia;
• fungal infections.

ESR during pregnancy

During pregnancy, ESR depends on the woman's physique and age.

• Overweight women in the first half of pregnancy have an indicator in the range of 17-47 mm / hour, in the second half - from 31 to 69 mm / hour.
• For thin people, it is normal to be 21-62 and 39-64 mm per hour, respectively, in the first and second periods of the gestation period.

ESR depends on the level of hemoglobin. The average value is up to 45 mm / h. Due to the high level of plasma, globulins, cholesterol in women, ESR during pregnancy reaches 55 mm / hour. It normalizes within a month after childbirth.

Methods for determining ESR in blood

Several methods are used to determine the level of ESR in the blood. The most common laboratory methods are Panchenkov and Westergren. Methods differ in the method of sampling material, the accuracy of the results. What is ESR according to Westergren and ESR according to Panchenkov, what other methods are there, the differences between them are presented in the table.

As a result of the study, the distance traveled by erythrocytes in 60 minutes is determined. The ESR depends on the viscosity, plasma density, and element diameter. Nowadays, automated counters are often used for blood analysis, where there is no need to manually dilute the biomaterial and monitor the change in sediment.

Features of preparation for a blood test for ESR

For correct blood sampling for ESR analysis, you cannot eat about 4 hours before the procedure. Serious fatty breakfast will show a false increase in the indicator. The ingress of air bubbles into the blood sample is not allowed. When taking blood from a finger, the puncture should be sufficient for blood to flow out without pressure. When squeezing out, most of the erythrocytes are destroyed, which leads to unreliable results.

Diseases in which there is an increased ESR in the blood

The most common causes of increased ESR are the development of infectious processes in tissues and organs, and inflammatory diseases. The factors leading to a high ESR in the blood include:

• bacterial, fungal, viral infections of the respiratory tract, urinary system, often accompanied by leukocytosis;
• autoimmune diseases that oversaturate the blood plasma with immune complexes (lupus erythematosus, vasculitis, rheumatoid and rheumatoid arthritis, scleroderma, thrombocytopenic purpura);
• inflammation, accompanied by tissue necrosis, when the breakdown products of proteins enter the bloodstream (oncological formations, purulent, septic diseases, myocardial infarction, pulmonary tuberculosis);
• endocrine pathologies that disrupt metabolism (diabetes mellitus, thyrotoxicosis, hypothyroidism);
• diseases of the kidneys, liver, intestines, pancreas;
• hemoblastosis (myeloma, leukemia, lymphogranulomatosis);
• oncological degeneration of the bone marrow;
• poisoning with arsenic, lead;
• side effects of drugs;
• suffered injuries, postoperative period.

What does the low level of ESR in the blood say?

A low ESR means a decrease in their ability to combine due to a change in the shape of bodies, high blood viscosity, and a decrease in pH. This state of blood is observed in diseases:

• reactive erythrocytosis;
• obstructive jaundice;
• erythremia;
• high bilirubin;
• muscle atrophy;
• sickle cell anemia;
• exhaustion;
• epilepsy;
• hepatitis;
• anemia;
• poisoning with mercury, calcium preparations;
• pathology of the heart, blood vessels;
• insufficient blood circulation.

The ESR value will be low in vegetarians if they avoid eating meat and animal products.

With a low ESR, the patient may complain of fever, tachycardia, and hyperthermia.

How to return ESR to normal

The primary task is to identify the cause of the pathology. This may require additional instrumental, laboratory examinations. A specific condition is treated after diagnosis. For physiological reasons (menstruation, pregnancy, lactation period), deviations of the analysis value from the norm ESR normalizes after the influence of these factors.

If the ESR in the blood is reduced

The most common reasons for a decrease in the erythrocyte sedimentation rate are physiological processes. To bring the indicator back to normal, it is necessary to stop the action of the provoking factor - fasting, vegetarian nutrition, taking corticosteroids, and normalize the water-salt balance.

If ESR in the blood is increased

Medicines to reduce ESR should be prescribed exclusively by a general practitioner after diagnosing the disease that caused it. With a low level of hemoglobin in the blood, patients are prescribed B vitamins, iron preparations, folic acid. If rheumatic disease is diagnosed, corticosteroids are indicated.

Folk remedies help to improve overall well-being and blood composition. After agreement with the attending physician, to normalize the erythrocyte sedimentation rate, you can try beet juice, honey, tea with lemon or raspberries, infusion of linden, chamomile.

False positive result

In women, the level of ESR can increase as a result of temporary hormonal disruptions. The analysis can show false positive results in such cases:

• high cholesterol;
• after hepatitis B vaccination;
• taking contraceptives, vitamins of group A;
• obesity;
• elderly age.

An erroneous result occurs due to a violation of the technique of blood sampling using a non-sterile capillary. If there is a suspicion of a false positive result, it is recommended to retake the test after 7-10 days.

The erythrocyte sedimentation rate is a reaction, pronounced changes in the course of which indicate the presence of diseases in the body. It is indicated for suspected inflammatory or malignant processes.

But this reaction does not allow obtaining a sufficient amount of details about the pathology and is carried out in combination with other diagnostic methods. Included in the list of studies that relate to a clinical blood test.

The erythrocyte sedimentation rate in the blood - what is it?

Blood mixed with anti-clotting agents and left in the test tube at rest gradually stratifies.

Above is plasma, below are platelets and leukocytes, and at the very bottom are erythrocytes, which have the highest density index, and the rate of their deposition, which changes under the influence of a number of factors, indicates the presence or absence of pathological processes.

Negatively charged red blood cells do not stick together in the blood stream due to the presence of charge, but this changes when protein compounds appear in the plasma structures that are associated with disease. These include antibodies, fibrinogen, ceruloplasmin. They affect the acceleration of subsidence processes, which is revealed during the analysis.

Increased values \u200b\u200bof the content of bile acids do not lead to acceleration.

Most of the 55% of plasma is in human blood

How and how is the erythrocyte sedimentation rate measured?

The Panchenkov method for measuring the erythrocyte sedimentation rate is available and used in many medical institutions.

In a narrow container - Panchenkov's capillary - a substance is added that prevents coagulation processes... The blood taken for research is placed in the same container so that its level reaches the desired mark. After it is installed in Panchenkov's tripod, and the process of settling begins.

An hour later, the erythrocyte sedimentation rate is assessed and the result is recorded. The amount of plasma fluid that has collected in the top of the tube per hour shows how quickly the red blood cells descend.

Also widely used is the Westergren method of measuring the erythrocyte sedimentation rate, which involves the use of other equipment: special tubes and a scale.

The Westergren method better shows the degree of increase in the erythrocyte sedimentation rate, and the result can be obtained faster, but there are no pronounced differences when measuring blood with normal parameters in these methods.

What does erie subsidence look like?

Units

The erythrocyte sedimentation rate is estimated in millimeters, which the descending blood cells have passed in an hour (mm / h).

Normal indices of erythrocyte sedimentation rate

The ESR rate is associated with age and gender:

• In children in the first 28 days of life(provided that there are no pathologies), the erythrocyte sedimentation rate is in the range of 1 or 2 mm / h. At this age, the hematocrit is increased, and the amount of protein compounds is reduced, which determines these results. As they grow older, the level begins to rise and by six months it is 12-17 mm / h.
• In childhood and adolescence the results are at the level of 1-8 mm / h, which is close to the normal rates of erythrocyte sedimentation rate in men under 60 years of age.
• In adult malesthe norm is a reaction that is in the range of 1-10.
• In women of childbearing age the erythrocyte sedimentation rate is 2-15. This has to do with the action of testosterone and other androgens. There is also a change in the rate of the deposition processes depending on the cycle time: before and during menstruation, an increase in ESR is noted. Also, increased rates are recorded in the second half of pregnancy: the severity of the reaction grows and reaches a peak in the last days. This is influenced by an increase in the amount of plasma fluid, an increase in the concentration of cholesterol, globular proteins and a decrease in calcium levels.

Table showing fluctuations in ESR depending on gender and age:

To determine ESR according to Westergren and by the micromethod, blood is taken from a vein for research.

Panchenkov's method involves the use of capillary blood.

Deviations in the rate of the course of the reaction depend on the disease and its characteristics. The erythrocyte sedimentation rate can change significantly over a short period of time.

ESR increased: what does it mean and why is it dangerous?

ESR increases in the presence of a pathological process in the body and remains at the same level for a long time, even in cases where the disease has already been cured.

This is due to the influence of the disease on the structure of blood cells: it is disrupted, and the reaction will not change until the renewal of blood elements occurs.

Accelerated subsidence is observed with the following diseases:

Protein compounds that are in the plasma fluid and affect the mechanism for increasing or decreasing ESR are called agglomeres.

Features of ESR change:

• A rapid increase in values \u200b\u200bup to 60-80 and more is observed in malignant neoplasms (lymphosarcoma, myeloma).
• Early tuberculosis does not affect the values, but without treatment and in the presence of complications, the values \u200b\u200bwill increase.
• In acute infectious processes, an increase is noted not immediately, but on the second or third day.
• The study is useless in the diagnosis of appendicitis and some other pathologies in which the values \u200b\u200bdo not increase immediately.
• Rheumatic diseases can be accompanied by minor deviations in values, but a drop in numbers is noted when complications from the heart occur.

Causes of increased ESR, not associated with pathologies

An increase in the erythrocyte sedimentation rate does not always mean the presence of a pathological process.

There are a number of conditions in which an accelerated reaction does not report violations:

• Period of menstruation,
• Food intake,
• Fasting, adherence to strict diets,
• Exhaustion after illness,
• Introduction of plasma liquid and its substitutes,
• Taking vitamin and mineral complexes,
• Certain medications (oral contraceptives, glucocorticosteroids, dextrans)
• High physical activity,
• Intense stress
• Lactation,
• The period after vaccination.

Physiological changes rarely cause significant increases or decreases in speed.

What does the reduced erythrocyte sedimentation rate indicate?

If the erythrocyte sedimentation rate is reduced, this indicates the presence of the following pathologies:

• Excessive blood density
• Change in the shape of erythrocytes (acquired or congenital disorders: spherocytosis, sickle cell anemia),
• Decrease in blood hydrogen parameters,
• Vakez disease
• Obstructive jaundice
• Excessive bilirubin,
• Deviations in the mechanisms of blood supply,
• Falling fibrinogen concentration.

The drop in erythrocyte sedimentation rate indicators is not considered by doctors to be a valuable diagnostic value.

Let's analyze a very common situation - ESR is higher than normal. What does it mean if the erythrocyte sedimentation rate is increased? And how quickly to recover!

An increase in the ESR value does not stand out as an independent pathology. This indicator is a marker of inflammatory processes of various etiologies.

This is because red blood cells are sensitive to the protein composition of the blood. It will change with the release of specific protective proteins as a reaction to the penetration of infection, the occurrence of malignant neoplasms, or the development of inflammatory autoimmune pathologies.

The price of the analysis for private clinics starts from 100 rubles, the execution time is up to 24 hours.

It is necessary to understand the difference in methods for measuring the value of the indicator, what its increase leads to, and what methods of correcting the condition exist.

The erythrocyte sedimentation rate (ESR) is included in the complete blood count.

The specificity of the method is extremely low and does not allow to accurately determine the patient's disease. Despite this, an increased ESR in the blood is a fairly weighty reason for a full examination of the patient.

The erythrocyte sedimentation rate is always assessed in conjunction with other indicators of general and biochemical blood tests.

In various sources, you can find a synonym for the term - the erythrocyte sedimentation reaction. A person receives a referral from a therapist, pediatrician, gynecologist, infectious disease specialist, endocrinologist, hematologist or surgeon.

What is accelerated ESR syndrome?

Average statistical data: in 5-10% of the population of people, the indicator is at the upper limit of the norm or above it for a long time. According to the International Classification of Diseases 10 revision (according to ICD 10), the accelerated ESR syndrome is assigned the code R70.0.

The syndrome can be a sign of the manifestation of another pathology or be an independent deviation.

The essence of the analysis

The principle of the analysis is based on the ability of red blood cells to settle in the liquid medium of the blood. An important condition for research is the creation of an environment as close as possible to natural. The blood to be tested should not clot, and erythrocytes should not decay (hemolysis). For this, a special anticoagulant is added to the test tube to prevent the clotting process. And the correct taking of the biomaterial guarantees the absence of hemolysis.

Why do erythrocytes settle? The sedimentation phenomenon is explained by the fact that red blood cells have a significantly greater weight than plasma. The speed of the process is determined by the level of their aggregation (sticking together). The adhered erythrocytes change the proportional ratio of the area of \u200b\u200bcells to their volume. There is a decrease in the resistance of adhered cells to friction, compared with individual red blood cells. The aggregate of adhered cells becomes heavier and settles faster.

Normally, erythrocytes in humans repel each other in view of the same negative electrical charge. Two factors contribute to their adhesion:

• the value of the surface potential of the cytoplasmic membrane;
• the percentage of plasma proteins.

A direct relationship has been established: the more protein components, the higher the probability of erythrocyte clumping. In parallel with this, there is an increase in ESR in the blood plasma.

Determination of ESR according to Panchenkov

The technique is implemented using a sterile graduated capillary with a maximum of 100 mm. The analysis is performed from venous or capillary blood.

At the first stage, the anticoagulant solution is taken up to a special mark "P", then it is poured onto a laboratory watch glass.

The second stage - the studied biomaterial is collected by the same capillary up to the “K” mark twice. Then the blood is poured onto a glass with an anticoagulant solution. The resulting ratio of biomaterial and anticoagulant is 4: 1.

The third stage - the biomaterial is carefully and thoroughly mixed with the solution and collected by a capillary to the “K” mark.

The final stage - a capillary with the required volume of collected blood with an anticoagulant is placed in a vertical holder-holder.

The control time of measurement depends on the purpose of the research and varies from 1 to 24 hours. The result is expressed in mm / h.

ESR blood test according to Westergren

This technique is recognized by WHO as an international standard and is considered a reference. The date of development of the ESR method according to Westergren is 1926.

The sensitivity of this research method is higher than that of Panchenkov's method.

Biomaterial - blood taken from the cubital vein at the elbow. The ratio of anticoagulant and biomaterial 4 to 1 can be obtained in the same way as in the previous method.

As a solution that prevents blood clotting, use:

• 3.8% sodium citrate solution;
• ethylenediaminetetraacetic acid (EDTA) + saline.

The research requires specialized laboratory tubes named after the scientist who developed the technique. The clearance of the test tube is 2.4 mm, an error of 0.1 mm is allowed. Graduated from 0 to 200 mm.

It is permissible to use non-graduated test tubes; in this case, a graduated rack is required.

The first control measurement is carried out after 1 hour, then - if necessary. Results are expressed in mm / h.

Differences between methods for determining ESR according to Panchenkov and Westergren

The main difference is the instruments used to measure the laboratory criterion. In view of this, the sensitivity of the techniques is different. ESR method according to Panchenkov is inferior in the degree of sensitivity to changes in ESR analysis according to Westergren.

In addition, a distinctive advantage of the Westergren method is the maximum scale of 200 mm. This is twice the comparison method.

Important: in the final results, the laboratory must indicate the method used for each patient.

However, the results of both studies should be correlated with each other. So, if the ESR indicator according to Panchenkov is increased, then the overestimated values \u200b\u200bshould be determined by the Westergren method.

The latest techniques

Modern laboratory departments are moving to the automation of all research. This greatly increases the accuracy and reliability of all analyzes, since the human factor is minimized.

Alternative techniques have been developed that are carried out by automatic analyzers. If it is impossible to take venous blood, analyzers perform a micro-method study.

The use of mathematical algorithms can significantly reduce the time for issuing results. The data obtained are reduced to the standard values \u200b\u200bof classical scales and are expressed in similar units.

What does this mean if the ESR (erythrocyte sedimentation rate) is higher than normal?

It should be emphasized that the study is characterized by low specificity. Which makes it impossible to make a diagnosis based on it. It only allows you to determine the need for additional laboratory tests.

However, there are cases when an increased content of ESR in the blood was determined in people without diseases. And vice versa: in patients with oncology or systemic diseases, normal values \u200b\u200bof the indicator were revealed.

So, increased ESR in the blood. What does this mean in women and men:

Infectious diseases

The first reason for the high level of ESR in the blood, which is assumed by the doctor, is an infectious inflammatory process. The severity and stage of the disease does not matter: acute or chronic. The indicator reacts especially sharply to a bacterial infection, therefore, if the ESR sharply rises in a person with a cold, the presence of bacterial complications should be suspected.

Autoimmune inflammatory processes are also accompanied by a deviation of the indicator upward. Therefore, first of all, these reasons should be excluded.

If the patient complains of stomach pain, chronic diarrhea, rectal fissures, high fever, loss of appetite and his erythrocyte sedimentation rate is increased, then a diagnosis is made for specific intestinal diseases. For example, Crohn's disease or ulcerative colitis.

Heart disease

A sad trend in recent decades: myocardial infarction is increasingly common in patients under 40. Previously, the pathology was found in people at least 60 years old. According to statistics, it occupies a leading position in the causes of death in the Russian Federation.

The pathology is characterized by acute myocardial necrosis against the background of obstruction of the coronary arteries. Delay in hospitalization and the provision of competent medical care leads to irreversible damage to the heart muscle.

The highest level of ESR is recorded after 5 - 7 days. This is the result of the systemic inflammatory response of the human body.

It should be noted that the prognosis of the outcome depends on several factors:

• the spread of necrosis;
• concomitant chronic pathologies;
• timeliness and literacy of medical care;
• the age of the patient and the presence of aggravating pathologies.

Therefore, an increased ESR in the blood of women after 50 years is a reason for regular examinations in order to identify early signs of the disease that have not yet manifested themselves as clinical symptoms.

Oncology

Multiple myeloma is the formation of a malignant neoplasm from plasma cells. The disease is accompanied by an excessive production of abnormal proteins that lead to accelerated adhesion of red blood cells. A typical feature is the formation of specific "coin bars" from erythrocytes.

Therefore, myeloma is one of the reasons for the critical increase in ESR in men and women, the indicators reach 50 - 80 mm / h. At the same time, the maximum rate for men is 15 - 20 mm / h, for women - 20 - 30 mm / h.

For malignant granulomas, changes in ESR are a typical clinical sign. The indicator is referred to as prognostic factors. If the value of the criterion is less than 50 mm / h, then a conclusion is made about a favorable prognosis.

Combination of factors: age is more than 40 years, ESR is above 50 mm / h and lymph node involvement allows the patient to be considered at risk. Even if at the time of the study he did not have any symptoms of the disease, he should be regularly examined and monitored.

For oncology of various localization, the achievement of extremely high values \u200b\u200b(more than 50 -80 mm / h) indicates metastases to adjacent organs and tissues.

Causes of low hemoglobin and high ESR

Normally, the value of ESR and hemoglobin are inversely related. The higher the hemoglobin, the lower the ESR. Therefore, a combined decrease in iron-containing protein and an increase in ESR is interpreted as an abnormal symptom requiring immediate identification of the cause.

Initially, the doctor will review the patient's medical record and compare the data obtained with previous indicators. Then the patient is assigned repeated tests to reliably eliminate errors due to improper preparation and accidental replacement of samples from different patients.

In parallel, analyzes for fibrinogen, acute phase proteins and C-reactive protein are performed. A study of serum proteins using electrophoresis is prescribed. To exclude multiple myeloma, a test is made to detect the level of immunoglobulins of various classes.

If necessary, a large-scale screening study of the patient is prescribed.

It should be borne in mind that a high level of ESR and low hemoglobin accompanies conditions in which a person has lost a large amount of blood.

Also, such test indicators can be observed in the presence of infection in a patient with anemia.

How to reduce ESR in the blood at home quickly and effectively?

Trying to independently adjust the value of the indicator without consulting a doctor is not advisable. Since the methods must be selected taking into account the root cause that caused the increase in the erythrocyte sedimentation rate.

This does not exclude the patient's responsibility for his health and does not relieve him of the obligation to maintain a healthy lifestyle, rational nutrition and optimal physical activity.

Based on the direct relationship between hemoglobin and the rate of sedimentation of red blood cells, the level of iron and B vitamins should initially be increased. You can get them from lean meats, peanuts, cheese, beets, milk, sour cream, blackberries and prunes.

If anemia is detected, the question of the need for the selection of drug therapy is decided.

If a person has rheumatoid arthritis, then he is prescribed complex treatment with the use of anti-inflammatory drugs and glucocorticosteroid hormones. It should be borne in mind that the therapy of the disease is a long process that goes through the stages of selection and correction of the methods used.

Infectious infections are treated with antimicrobial drugs. The drug itself is selected depending on the type of pathogen and its sensitivity.

The lack of positive dynamics in reducing the ESR value indicates the ineffectiveness of the selected techniques.

Particular attention is paid to the treatment of cancer. Here, the solution to the issue of stopping the spread of oncopathology and preventing relapse comes to the fore.

How to use folk remedies to lower ESR in the blood of women and men?

If the patient has a cold disease, then treatment with honey and onions can be supplemented. It is known that beekeeping products have antimicrobial properties and slow down the development of pathogenic bacteria. At the same time, the patient should not be allergic to honey. Onions release substances that also have a detrimental effect on pathogenic microflora.

Graduated specialist, in 2014 she graduated with honors from the Federal State Budgetary Educational Institution of Higher Education Orenburg State University with a degree in microbiology. Graduate of the postgraduate study at the Orenburg State Agrarian University.

In 2015. at the Institute of Cellular and Intracellular Symbiosis of the Ural Branch of the Russian Academy of Sciences, she underwent advanced training under the additional professional program "Bacteriology".

Laureate of the All-Russian competition for the best scientific work in the nomination "Biological Sciences" 2017.

The erythrocyte sedimentation rate (syn. ESR) is a non-specific parameter that can be measured only during a general clinical blood test. The obtained values \u200b\u200bindicate the ratio of various fractions of proteins contained in the plasma of the main human biological fluid. The material under study can be taken from both a finger and a vein.

The indicator has the values \u200b\u200bof the norm, which differ not only in the age category, but also depending on the sex of the person. In accordance with this, the permissible numbers can be lowered or raised, which indicates the course of a disease in the body. The parameter can be influenced by some physiological reasons, for example, the period of bearing the baby and old age.

Several methods are currently used to assess the reaction, but the most common of them is the Westergren method. To get accurate readings, clinicians advise patients to follow a few simple preparation rules.

ESR in a general blood test

The essence of the laboratory test for erythrocyte sedimentation rate (ESR) is that red blood cells are the heaviest formed component of the blood.

If for a short period of time the flask with blood is installed in an upright position, the biofluid under the influence of gravity is divided into several fractions - a thick sediment of erythrocytes and translucent plasma in combination with the rest of the particles.

Erythrocytes have several features, for example, cells can "stick together" to each other, causing the sedimentation of red blood cells to accelerate or slow down - the sedimentation rate can be high or not.

The accuracy of the study of erythrocyte sedimentation in the blood is dictated by several factors:

• correct preparation of the patient for analysis;
• the qualification level of the laboratory assistant who conducts the study;
• the quality of the reagents used.

Only if these requirements are met, the result will be the most correct.

Preparatory activities and blood sampling

The erythrocyte sedimentation rate indicates the presence and intensity of inflammation in the human body. The study is indicated not only for monitoring the treatment of pathologies, but also for prophylactic purposes.

In cases of detecting any deviations from the norm in an adult or a child, the patient will be sent for biochemical analysis. This need is due to the fact that ESR is a nonspecific parameter, on the basis of which it is rather difficult to make a correct diagnosis.

Donating blood does not require any complex or lengthy preparation from patients. The main rule is the complete refusal of food and alcohol at least 4 hours before visiting a medical institution. It is allowed to drink purified water without gas or unsweetened tea.

The direct collection of biological material takes no more than 10 minutes, but the sequence of the process will differ depending on what kind of blood is needed for the laboratory test.

If the patient has been prescribed a fingerprint test, the sequence for taking biofluid will include the following steps:

• rubbing the ring finger of the left or right hand with alcohol;
• making a shallow cut, no more than 2-3 millimeters, using a special tool;
• removing the first drop of blood with a sterile dressing;
• sampling of biological fluid;
• disinfection of the puncture site;
• applying a piece of cotton wool soaked in an antiseptic solution to the pad of the finger is necessary to quickly stop bleeding.

As for taking venous blood from men or women, in this situation, the sequence of actions of the laboratory assistant will be as follows:

• pulling the patient's forearm with a rubber band;
• disinfection of the puncture site with alcohol;
• insertion of a needle into the vein of the elbow;
• collection of the required amount of biomaterial in a test tube;
• removing the needle from the vein;
• repeated disinfection;
• bending the arm at the elbow to stop bleeding.

In children, blood sampling is carried out in the same way.

Analysis methods

Currently, the determination of the erythrocyte sedimentation rate is carried out by 2 methods - according to Panchenkov and according to Westergren. The methods have one thing in common - before the study, the blood is mixed with an anticoagulant so that the biofluid does not clot. The difference lies in the type of liquid under study and the accuracy of the results, which the hematologist is engaged in decoding.

For a blood test according to Panchenkov, a capillary liquid and a special thin glass pipette (Panchenkov's capillary), graduated to 100 divisions, are required. First of all, a certain amount of anticoagulant is applied, after which the biomaterial is added in a ratio of 1 to 4. The capillary is set vertically for 1 hour, after which the plasma height is measured, not taking into account the erythrocyte sediment. The unit of the obtained parameter is millimeter.

A more common and sensitive method is the Westergren method of studying blood. The main difference is the use of a more accurate scale (200 divisions) with a graduation per millimeter, which is why ESR is measured in mm / h.

In this case, the studied liquid is capillary blood, which is mixed with an anticoagulant. The test tube is placed in an upright position for 1 hour, after which the plasma column is to be measured.

After the erythrocyte sedimentation reaction has become known, the results are reported to the attending physician, who, if necessary, prescribes additional laboratory tests, instrumental procedures and consultations with specialists from other fields of medicine.

Indicators of the norm

The erythrocyte sedimentation rate depends on the sex and age of the person.

The erythrocyte sedimentation rate in women during the period of bearing a child will differ:

Any deviation of the parameter in a woman up or down has pathological reasons.

Deviations from acceptable parameters

The main sources of increased erythrocyte sedimentation rate are:

• a wide range of infections, such as sepsis, pneumonia, tuberculosis, rheumatism;
• myocardial infarction;
• diabetes;
• thyrotoxicosis and other pathologies of the endocrine system;
• rheumatoid arthritis;
• diseases of the liver, kidneys, biliary tract and gastrointestinal tract;
• poisoning of the body with chemicals;
• malignant neoplasms;
• blood diseases, in particular anemia and lymphogranulomatosis;
• postoperative conditions;
• various injuries and fractures;
• overdose of certain medications;
• cardiogenic, painful or anaphylactic shock;
• extensive burns.

When the erythrocyte sedimentation rate is increased, this does not always indicate the course of any disease, the reasons may be physiological:

• advanced age;
• the flow of menstruation;
• excess body weight;
• postpartum recovery.

There are a number of conditions against which a false increase in ESR can develop. These phenomena include:

• high cholesterol;
• long-term use of medications containing vitamin A;
• recent vaccination against hepatitis;
• the use of oral contraceptives.

ESR increases during pregnancy, and regardless of the period.

The reasons for the growth of the indicator in a child:

• infectious and inflammatory processes;
• bronchial asthma;
• pulmonary and extrapulmonary forms of tuberculosis;
• metabolic pathology;
• trauma.

Low red blood cell sedimentation rate most often develops against a background of:

• irregularly shaped erythrocytes - spherocytosis or sickle;
• erythremia;
• obstructive jaundice;
• sickle cell anemia;
• increasing the content of bilirubin;
• polycythemia;
• reactive erythrocytosis;
• hypofibrinogenemia;
• chronic circulatory failure;
• disorders of water-salt metabolism;
• myodystrophy;
• overhydration;
• prolonged fasting or overly strict diets;
• irrational use of drugs.

In males, a decrease in ESR is extremely rare.

As for the clinical manifestations of any deviation from the permissible values, they do not exist. This means that the symptomatology is limited to the expression of the external manifestations of the underlying disease.

The normalization of ESR depends on the elimination of the cause of the pathology, that is, the parameter is restored only after the provoking factor is completely eliminated.

To prevent a decrease or increase in the rate of sedimentation of red blood cells, it is necessary to give up bad habits, eat right, lead a moderately active lifestyle, and undergo a full medical examination several times a year.

Sedimentation rate of erythrocytes (ESR) is a laboratory test that evaluates the rate of blood separation into plasma and erythrocytes. Research essence: erythrocytes are heavier than plasma and leukocytes, therefore, under the influence of gravity, they sink to the bottom of the tube. In healthy people, erythrocyte membranes have a negative charge and repel each other, which slows down the rate of sedimentation. But during illness, a number of changes occur in the blood:

Content increases fibrinogenas well as alpha and gamma globulins and C-reactive protein. They accumulate on the surface of erythrocytes and cause them to stick together in the form of coin columns;

Decreased concentration albuminthat prevents red blood cells from sticking together;

Violated electrolyte balance of blood... This leads to a change in the charge of erythrocytes, due to which they cease to repel.

As a result, the red blood cells stick together. Clusters are heavier than individual erythrocytes, they sink to the bottom faster, as a result of which erythrocyte sedimentation rate increases... There are four groups of diseases that cause an increase in ESR:

infections

malignant tumors

rheumatological (systemic) diseases

kidney disease

What you need to know about ESR

The definition is not a specific analysis. ESR can increase in numerous diseases that cause quantitative and qualitative changes in plasma proteins.

In 2% of patients (even with serious diseases), the ESR level remains normal.

ESR increases not from the first hours, but on the 2nd day of the disease.

After illness, ESR remains elevated for several weeks, sometimes months. This indicates recovery.

Sometimes ESR rises to 100 mm / hour in healthy people.

ESR rises after eating up to 25 mm / hour, so tests must be taken on an empty stomach.

If the temperature in the laboratory is above 24 degrees, then the process of gluing erythrocytes is disrupted and the ESR decreases.

ESR is an integral part of a general blood test.

The essence of the method for determining the erythrocyte sedimentation rate? The World Health Organization (WHO) recommends the Westergren method. It is used by modern laboratories to determine ESR. But in municipal clinics and hospitals, the Panchenkov method is traditionally used. Westergren's method. Mix 2 ml of venous blood and 0.5 ml of sodium citrate, an anticoagulant that prevents blood clotting. The mixture is collected in a thin cylindrical tube to a level of 200 mm. The tube is vertically placed in a rack. An hour later, the distance from the upper border of the plasma to the level of erythrocytes is measured in millimeters. Automatic ESR counters are often used. ESR unit - mm / hour. Panchenkov's method. Capillary blood from a finger is examined. In a glass pipette, 1 mm in diameter, take up a solution of sodium citrate to the mark of 50 mm. It is blown into a test tube. After that, 2 times with a pipette, take blood and blow it into a test tube to sodium citrate. Thus, the ratio of anticoagulant to blood is 1: 4. This mixture is drawn into a glass capillary to a level of 100 mm and is set in a vertical position. The results are evaluated after one hour, as with the Westergren method.

Determination according to Westergren is considered a more sensitive technique, therefore the level of ESR is slightly higher than in the study by the Panchenkov method.

It must be remembered that uncomplicated viral infections do not cause an increase in ESR. This diagnostic sign helps to determine that the disease is caused by bacteria. Therefore, with an increase in ESR, antibiotics are often prescribed. The erythrocyte sedimentation rate of 1-4 mm / h is considered slow. This reaction occurs when the level of fibrinogen, which is responsible for blood clotting, decreases. And also with an increase in the negative charge of erythrocytes as a result of changes in the electrolyte balance of the blood. It should be noted that taking these drugs can cause a falsely low ESR result in bacterial infections and rheumatoid diseases.