Increased erythrocyte sedimentation rate in the blood. ESR (erythrocyte sedimentation rate)
ESR analysis is considered to be one of the main indicators of infectious diseases. In fact, deciphering the results of a general blood test is not the final conclusion about the patient's state of health. In order for the diagnostic results to be as correct as possible, it is required to conduct a repeated study of ESR in the patient's blood, the norm of which is determined as a result of a statistical study of healthy people, as well as other clinical methods of examination, over a certain period.
The ESR level indicator is not a sign of any particular disease. Usually, its reference values are used in combination with indicators of other blood bodies.
Method for determining the erythrocyte sedimentation rate
The erythrocyte sedimentation rate in the laboratory is determined using one of two methodologies: Panchenkov or Westergren. In both cases, the unit of measure is the level of the column in terms of the height of the red bodies in millimeters, which was formed in a unit of time - one hour. The analysis is carried out by adding sodium citrate to the collected material, which prevents blood clotting.
Within an hour, heavier erythrocytes settle to the bottom of the tube. The more erythrocytes in the blood, the slower the sedimentation process occurs and vice versa - a decrease in their number (for example, with anemia) accelerates their movement under gravitational conditions. Thus, the analysis shows the result: the norm, an increase or decrease in ESR.
ESR norm for adults and children: indicators with decoding
Normal indicators for men and women
The concept of the ESR norm for men and women is different, the same applies to age categories. So men under the age of 50 normally have an ESR of 1-10 mm / h. The norm of ESR in the blood of a woman is 3-15 mm (under the age of 30), 8-25 mm / h (30 - 60 years), for those women who are over 60 - 12-53 mm / h. Men over 50 have a normal rate of 2–20 mm/hour.
ESR blood test indicator in children
Children up to six months 2-17 mm / h, in addition, in many children, the ESR is unstable, depends on nutrition, a complex of vitamins, and body growth processes. Parents should worry only if the general blood test shows an overestimation or underestimation of the level of other indicators monitored in dynamics.
The level of ESR in the blood: the norm in women in position
Separately, it is necessary to highlight the category of women who are in position. Already at 10–11 weeks, their ESR rate is 25–45 mm / h and remains at the level for 4 weeks after childbirth. If the pregnancy proceeds normally, then in the dynamics the analysis will show the results within the indicated limits. This level of ESR is associated with a change in the composition of the blood, namely with an increase in protein mass as a percentage.
Reasons for increasing or decreasing the level of "SOI"
There are several reasons for the change in erythrocyte sedimentation rate in adulthood. In patients with chronic infectious diseases, the “norm” indicator will be exceeded by 15–30 units. This applies to inflammation of the upper respiratory tract, diseases of the genitourinary system, anemia, autoimmune diseases, intoxication and injuries with a state of shock. Even when taking oral contraceptives, women noted an increase in ESR.
Malignant neoplasms, purulent-septic processes in the body increase the ESR significantly - the norm deviates by 30–60 units. In this case, the patient already feels the problem, and deciphering other types of tests allows you to make an accurate diagnosis.
A low level is observed with an increase in the level of concentration of yellow salts in the blood, a change in the values of the erythrocytes themselves. Reduction is possible with a vegetarian diet, taking certain drugs that thin the blood, myodystrophy, in the first two semesters of pregnancy.
Deviation from the norm indicates the beginning of any inflammatory processes. But if you prepare for the analysis incorrectly, the data will also be fuzzy and their decoding will not give a correct result that corresponds to reality. You just need to take the test on an empty stomach, at least an hour after eating, preferably in the morning. The day before, you should not overeat, abuse fatty and spicy foods, drink alcohol. You should also refrain from smoking for an hour before blood sampling. In the laboratory itself, you should not worry, it is better to rest for 10-15 minutes and calm down - this is just a prick in the finger, which is practically not noticeable.
Video: "SOYA" in the blood - the norm in adults
If there is a need to undergo an examination, the doctor will definitely prescribe a general blood test. Indicators of the level of erythrocytes, leukocytes, platelets will draw a picture of the state of the human body in a given period of his life.
[02-007 ] Erythrocyte sedimentation rate (ESR)
190 rub.
To order
A test that evaluates the rate at which blood separates into plasma and red blood cells. The rate of separation is mainly determined by the degree of their aggregation, i.e., the ability to stick together with each other.
Russian synonyms
Erythrocyte sedimentation reaction, ROE, ESR.
SynonymsEnglish
Erythrocyte sedimentation rate, Sed rate, Sedimentation rate, Westergren sedimentation rate.
Research method
Method of capillary photometry.
Units
mm/h (millimeter per hour).
What biomaterial can be used for research?
Venous, capillary blood.
How to properly prepare for research?
- Eliminate alcohol from the diet for 24 hours prior to the study.
- Do not eat for 2-3 hours before the study (you can drink clean non-carbonated water).
- Stop taking medicines 24 hours before the study (as agreed with the doctor).
- Eliminate physical and emotional overstrain for 30 minutes before the study.
- Do not smoke for 30 minutes prior to the study.
General information about the study
Determination of the erythrocyte sedimentation rate (ESR) is an indirect method for detecting an inflammatory, autoimmune, or oncological disease. It is performed on a sample of venous or capillary blood, which has been added to a substance that allows it not to clot (anticoagulant). When analyzing ESR by the Panchenkov method, blood is placed in a thin glass or plastic test tube and monitored for an hour. At this time, erythrocytes (red blood cells), as having a large specific gravity, settle, leaving a column of transparent plasma above them. According to the distance from the upper border of the plasma to the erythrocytes, the ESR is calculated. Normally, red blood cells settle slowly, leaving very little pure plasma. For this method, a Panchenkov apparatus is used, consisting of a stand and capillary pipettes with a scale of 100 mm.
In capillary photometry (automatic analyzers ROLLER, TEST1) the kinetic method of "stopped jet" is used. At the beginning of the ESR analysis, a programmed mixing of the sample takes place in order to disaggregate the erythrocytes. Ineffective disaggregation or the presence of microclots can affect the final result, since the analyzer actually measures the kinetics of erythrocyte aggregation. In this case, the measurement takes place in the range from 2 to 120 mm / h. The results of measuring ESR by this method have a high correlation with the Westergren method, which is the reference for determining ESR in the blood, and the same reference values.
The results obtained when using the method of capillary photometry, in the region of normal values, coincide with the results obtained when determining the ESR by the Panchenkov method. However, the method of capillary photometry is more sensitive to an increase in ESR, and the results in the zone elevated values higher than the results obtained by the Panchenkov method.
An increase in the level of pathological proteins in the liquid part of the blood, as well as some other proteins (the so-called acute-phase proteins that appear during inflammation) contributes to the "gluing" of red blood cells. Because of this, they settle faster and the ESR rises. It turns out that any acute or chronic inflammation can lead to an increase in ESR in the blood.
The fewer red blood cells, the faster they settle, so women have a higher ESR than men. The norm of ESR is different depending on gender and age.
What is research used for?
- For the diagnosis of diseases associated with acute or chronic inflammation including infections, cancers and autoimmune diseases. The determination of ESR is sensitive, but one of the least specific laboratory tests, since an increase in ESR in the blood alone does not allow determining the source of inflammation, in addition, it can occur not only due to inflammation. That is why the ESR analysis is usually used in combination with other studies.
When is the study scheduled?
- During diagnostics and monitoring:
- inflammatory diseases,
- infectious diseases,
- oncological diseases,
- autoimmune diseases.
- When conducting preventive examinations in conjunction with other studies (general blood count, leukocyte formula, etc.).
What do the results mean?
Reference values (ESR norm - table)
The results of this analysis must be interpreted in the light of clinical findings, medical history, and other analyses.
Causes of increased ESR in the blood
- Infectious diseases (often bacterial cause). ESR can increase in both acute and chronic infectious diseases.
- Inflammatory diseases.
- Connective tissue diseases ( rheumatoid arthritis, systemic lupus erythematosus, systemic scleroderma, vasculitis).
- Inflammatory bowel disease (Crohn's disease, ulcerative colitis).
- Oncological diseases:
- Myeloma. As a rule, it is accompanied by a very high level of ESR in the blood, because with it pathological proteins are synthesized in large quantities, which cause the formation of erythrocyte "coin columns".
- Hodgkin's disease is a malignant disease lymph nodes. The ESR indicator is usually used not to make a diagnosis, but to monitor the course and effectiveness of treatment of an already diagnosed disease.
- Cancer of various localizations, especially hemoblastoses. It is believed that an extremely high level of ESR in the blood indicates the spread of the tumor beyond primary focus(i.e. about metastases).
- Myocardial infarction. With it, damage to the heart muscle occurs, which causes a systemic inflammatory response and, accordingly, an increase in ESR. After a heart attack, ESR peaks about a week later.
- Anemia. A decrease in the number of erythrocytes can lead to an increase in their sedimentation rate.
- Burns, injuries.
- Amyloidosis is a disease associated with the accumulation of an abnormal protein in the tissues.
Causes of a decrease in ESR in the blood
- Diseases that are accompanied by a change in the shape of red blood cells, such as sickle cell anemia or hereditary spherocytosis (these make it difficult for red blood cells to settle).
- Polycythemia (an increase in the number of red blood cells) and the conditions that lead to it, such as, for example, chronic heart failure or lung disease.
What can influence the result? Leukocyte formula
Who orders the study?
Therapist, oncologist, hematologist, infectious disease specialist.
Medicine does not stand still - every day new diagnostic techniques appear and are introduced to identify the causes of changes occurring in human body and leading to disease.
Despite this, the definition of ESR has not lost its relevance and is actively used for diagnosis in adults and young patients. This study is mandatory and in all cases is indicative, whether it is a visit to a doctor due to a disease or a medical examination and preventive examination.
This diagnostic test is interpreted by a doctor of any specialty, and therefore belongs to the group general research blood. And, if the ESR blood test is elevated, the doctor must determine the cause.
What is soe?
ESR is a term formed from capital letters full name test - erythrocyte sedimentation rate. The simplicity of the name does not conceal any medical background, the test really determines the very erythrocyte sedimentation rate. Erythrocytes are red blood cells that, when exposed to anticoagulants, settle at the bottom of a medical test tube or capillary for a certain time.
The time of separation of the taken blood sample into two visible layers (upper and lower) is interpreted as the erythrocyte sedimentation rate and is estimated by the height of the plasma layer obtained as a result of the study in millimeters per hour.
ESR refers to non-specific indicators, but has a high sensitivity. By changing the ESR, the body can signal the development of a certain pathology (infectious, rheumatological, oncological and other) even before the onset of an obvious clinical picture, i.e. during a period of imaginary prosperity.
The erythrocyte sedimentation rate in the blood helps:
- differentiate the diagnosis, for example, angina pectoris and myocardial infarction, and osteoarthritis and rheumatoid arthritis, etc.
- determine the body's response during treatment for tuberculosis, Hodgkin's disease, disseminated lupus erythematosus, etc.
- to state a latent disease, however, even a normal ESR value does not exclude serious disease or malignancy
Diseases accompanied by high ESR
The erythrocyte sedimentation rate is of great diagnostic and medical importance if a disease is suspected. Of course, not a single doctor refers to the ESR alone when making a diagnosis. But together with the symptoms and results of instrumental and laboratory diagnostics he occupies a prominent position.
The erythrocyte sedimentation rate is almost always increased in most acute bacterial infections. The localization of the infectious process can be the most diverse, but the picture of peripheral blood will always reflect the severity of the inflammatory reaction. ESR also increases with the development of an infection of viral etiology.
In general, diseases in which an increase in ESR is a typical diagnostic sign can be divided into groups:
- Diseases of the liver and biliary tract (see);
- Purulent and septic diseases of an inflammatory nature;
- Diseases in the pathogenesis of which is the destruction and necrosis of tissues - heart attacks and strokes, malignant neoplasms, tuberculosis;
- - anisocytosis sickle anemia, hemoglobinopathies;
- metabolic diseases and pathological changes endocrine glands - diabetes, obesity, thyrotoxicosis, cystic fibrosis and others;
- Malignant transformation of the bone marrow, in which red blood cells are defective and enter the bloodstream unprepared to perform their functions (leukemia, myeloma, lymphoma);
- Acute conditions leading to an increase in blood viscosity - diarrhea, bleeding, intestinal obstruction, vomiting, condition after surgery;
- Autoimmune pathologies - lupus erythematosus, scleroderma, rheumatism, Sjögren's syndrome and others.
The highest rates of ESR (more than 100 mm/h) are typical for infectious processes:
- SARS, influenza, sinusitis, bronchitis, pneumonia, tuberculosis, etc.
- infections urinary tract(pyelonephritis, cystitis)
- viral hepatitis and fungal infections
- for a long time, high ESR can be in the oncological process.
It should be noted that during infectious processes, this indicator does not increase immediately, but one or two days after the onset of the disease, and after recovery for some time (up to several months), the ESR will be slightly increased.
ESR - norm and pathology
Since this indicator is normalized, there are physiological limits that are normal for various population groups. For children, the ESR rate varies depending on age.
Separately, such a condition of a woman as pregnancy is considered, in this period an increased ESR up to 45 mm / h is considered normal, while a pregnant woman does not need additional examination to detect pathology.
| Elevated ESR in a child | Among women | In men |
|
|
For men, the standards are also set according to age groups.
|
Methods for determining the ESR and interpretation of the results
V medical diagnostics several different methods for determining ESR are used, the results of which differ from each other and are not comparable with each other.
The essence of the Westergren method, widely practiced and approved by the International Committee for Standardization of Blood Research, is to study venous blood, which in a certain ratio is mixed with sodium citrate. The erythrocyte sedimentation rate is determined by measuring the tripod distance - from the upper border of the plasma to the upper border of the settled erythrocytes 1 hour after mixing and placing in a tripod. If it turns out that Westergren's ESR is increased, the result is more indicative for diagnosis, especially if the reaction is accelerated.
The Wintrob method consists in the study of undiluted blood mixed with an anticoagulant. The ESR is interpreted by the scale of the tube into which the blood is placed. The disadvantage of the method is the unreliability of the results at a rate above 60 mm / h due to clogging of the tube with settled erythrocytes.
Panchenkov's method consists in the study of capillary blood diluted with sodium citrate in a quantitative ratio of 4:1. Blood settles in a special capillary with 100 divisions. The result is evaluated after 1 hour.
Westergren's and Panchenkov's methods give the same results, but with increased ESR, Westergren's method shows higher values. Comparative analysis indicators are presented in the table (mm / h).
| Panchenkov's method | Westergren method |
| 15 | 14 |
| 16 | 15 |
| 20 | 18 |
| 22 | 20 |
| 30 | 26 |
| 36 | 30 |
| 40 | 33 |
| 49 | 40 |
It is worth noting that automatic counters for determining the erythrocyte sedimentation rate are now actively used, which do not require human participation in diluting a portion of blood and tracking the results. For correct decoding results, it is necessary to take into account the factors that determine the variations in this indicator.
In civilized countries, unlike Russia (with backward methods of diagnosis and treatment), ESR is no longer considered as an informative indicator of the inflammatory process, since it has a lot of both false positive and false negative results. But the CRP indicator (C-reactive protein) is an acute phase protein, an increase in which indicates a non-specific response of the body to a wide range of diseases - bacterial, viral, rheumatic, inflammation of the gallbladder and ducts, abdominal processes, tuberculosis, acute hepatitis, injuries, etc. .- is used very widely in Europe, it has practically replaced the ESR indicator, as more reliable.
Factors affecting this indicator
Many factors, both physiological and pathological, affect the ESR, among which the key ones are distinguished, i.e. most important:
- the ESR indicator in the female half of humanity is higher than in the male, which is due to the physiological characteristics of female blood;
- its value is higher in pregnant women than in non-pregnant women, and ranges from 20 to 45 mm / h;
- women taking contraceptives have an increased rate;
- people with anemia have high rate ESR;
- in the morning, the erythrocyte sedimentation rate is slightly higher than in the daytime and evening hours (typical for all people);
- acute-phase proteins lead to an acceleration of the erythrocyte sedimentation rate;
- with the development of an infectious and inflammatory process, the result of the analysis changes a day after the onset of hyperthermia and leukocytosis;
- in the presence of a chronic focus of inflammation, this indicator is always slightly increased;
- with increased blood viscosity, this indicator is below the physiological norm;
- anisocytes and spherocytes (morphological variants of erythrocytes) slow down the erythrocyte sedimentation rate, and macrocytes, on the contrary, accelerate the reaction.
If the ESR in the blood of a child is increased - what does this mean?
An increased ESR in the blood of a child most likely indicates an infectious-inflammatory process, which is determined not only by the result of the analysis. At the same time, other indicators of the general blood test will be changed, as well as in children infectious diseases always accompanied by disturbing symptoms and deterioration of the general condition. In addition, ESR may increase with non-communicable diseases in children:
- autoimmune or systemic diseases - rheumatoid arthritis, bronchial asthma, systemic lupus erythematosus
- with metabolic disorders - hyperthyroidism, diabetes mellitus, hypothyroidism
- with anemia, hemoblastoses, blood diseases
- diseases accompanied by tissue breakdown - oncological processes, pulmonary tuberculosis and extrapulmonary forms, myocardial infarction, etc.
- injury
It should be remembered that even after recovery, the increased erythrocyte sedimentation rate normalizes rather slowly, approximately 4-6 weeks after the illness, and if there is any doubt, in order to make sure that the inflammatory process has stopped, you can take an analysis for C-reactive protein (in a paid clinic) .
If a significant elevated ESR is found in a child, the reasons most likely lie in the development of an inflammatory reaction, therefore, in the case of pediatric diagnostics, it is not customary to talk about its safe increase.
The most harmless factors of a slight increase in this indicator in a child can be:
- if the ESR is slightly increased in the baby, this may be the result of a violation of the diet of a nursing mother (an abundance of fatty foods)
- taking medicines ()
- the time when the baby is teething
- vitamin deficiency
- helminthiases (see,)
Statistics on the frequency of increased ESR in various diseases
- 40% are infectious diseases - upper and lower respiratory tract, urinary tract, pulmonary tuberculosis and extrapulmonary forms, viral hepatitis, systemic fungal infections
- 23% - oncological diseases of the blood and any organs
- 17% - rheumatism, systemic lupus erythematosus
- 8% - anemia, cholelithiasis, inflammatory processes of the pancreas, intestines, pelvic organs (salpingoophoritis, prostatitis), diseases of the ENT organs (sinusitis, otitis media, tonsillitis), diabetes mellitus, injuries, pregnancy
- 3% - kidney disease
When is an increase in ESR considered safe?
Many people know that an increase in this indicator, as a rule, indicates some kind of inflammatory reaction. But this is not a golden rule. If an elevated ESR in the blood is found, the causes can be quite safe and do not require any treatment:
- allergic reactions, in which fluctuations in the initially increased erythrocyte sedimentation rate make it possible to judge the correct anti-allergic therapy - if the drug works, then the indicator will gradually decrease;
- a hearty breakfast before the study;
- fasting, strict diet;
- menstruation, pregnancy and the postpartum period in women.
Causes of false positive ESR tests
There is such a thing as a false positive analysis. The ESR test is considered false positive and does not indicate the development of infection in the presence of the following causes and factors:
- anemia, in which there is no morphological change in red blood cells;
- an increase in the concentration of all plasma proteins, except for fibrinogen;
- kidney failure;
- hypercholesterolemia;
- severe obesity;
- pregnancy;
- advanced age of the patient;
- technical errors in diagnostics (incorrect blood exposure time, temperature above 25 C, insufficient mixing of blood with an anticoagulant, etc.);
- the introduction of dextran;
- vaccination against hepatitis B;
- taking vitamin A.
What to do if the causes of increased ESR are not identified?
There are frequent cases when the reasons for the increased erythrocyte sedimentation rate are not found, and the analysis consistently shows high ESR in dynamics. In any case, in-depth diagnostics will be carried out in order to exclude dangerous processes and conditions (especially oncological pathology). In some cases, some people have such a feature of the body when the ESR is increased, regardless of the presence of the disease.
In this case, it is enough to undergo a preventive medical examination with your doctor once every six months, but if any symptoms occur, you should visit a medical institution in the near future. In this case, the phrase "God saves the safe" is an excellent motivation for an attentive attitude to one's own health!
The erythrocyte sedimentation rate (ESR) is an indicator that determines the speed and intensity of erythrocyte agglutination in certain pathological processes. This analysis is one of the mandatory values of the general blood test, previously the analysis was called ROE and determined the reaction of erythrocyte sedimentation.
Changes and deviations from the norm indicate inflammation and the development of the disease. That is why, in order to stabilize the ESR, the disease is initially treated, and not artificially attempted to achieve the norm with the help of drugs.
As a rule, excess of the norm indicates a violation of the electrochemical structure of the blood, as a result of which pathological proteins (fibrinogens) attach to red blood cells. The appearance of such elements occurs against the background of bacterial, viral, infectious and fungal lesions, inflammatory processes.
Indications
Important! ESR is a non-specific indicator. This means that in isolation from other data, on the basis of ESR alone, it is impossible to make a diagnosis. Deviations in the erythrocyte sedimentation rate indicate only the presence of pathological changes.
An ESR analysis is a necessary step in diagnosing the structure of the blood, which at the earliest stages of the disease makes it possible to determine the presence of inflammatory processes in the body.
That is why ESR is prescribed for suspected pathologies of various nature:
- inflammatory diseases;
- infectious;
- benign and malignant formations.
Additionally, screening is carried out at annual medical examinations.
ESR is used in the complex of clinical (general) analysis. After it, it is necessary to additionally use other diagnostic methods.
Even minor deviations from the norm must be considered conditionally pathological, requiring additional examination.
If a pathology of the hematopoietic system is suspected, the analysis of ESR becomes the main diagnostic value.
ESR norms
The erythrocyte sedimentation rate is measured in mm per hour.
ESR according to Westergren, ESR micromethod - venous blood is examined
ESR according to Panchenkov - capillary blood is examined (from a finger)
Depending on the type, form of the course (acute, chronic, recurrent) and the stage of development of the disease, ESR can change dramatically. To obtain a complete picture, a second study is carried out after 5 days.
ESR above normal
Important! A physiological increase in ESR can be observed in women during menstruation, during pregnancy and in the postpartum period.
As a rule, the erythrocyte sedimentation rate exceeds the norm in the following diseases:
- inflammatory processes of various etiologies. The indicator increases as a result of increased production of globulins and fibrinogens during the acute phase of inflammation;
- decay, tissue death, necrotic processes in cells. As a result of the breakdown, protein products enter the bloodstream, causing sepsis and purulent processes. This group includes oncological pathologies, tuberculosis, heart attacks (of the brain, myocardium, lungs, intestines), etc.;
- metabolic disorders - hypo- and hyperthyroidism, diabetes at all stages, etc.;
- nephrotic syndrome and hypoalbuminemia, liver pathology, severe blood loss, exhaustion;
- anemia (anemia), hemolysis, blood loss and other pathologies circulatory system. As a result of the disease, the number of red blood cells in the body is reduced .;
- vasculitis, connective tissue diseases: arthritis, periarteritis, scleroderma, rheumatism, lupus and many others;
- hemoblastosis of all types (leukemia, Waldenström's disease, lymphogranulomatosis and others);
- periodic hormonal changes in the female body (menstruation, childbearing and childbirth, the onset of menopause).
ESR below normal
Registered in the following cases:
- disorders of the circulatory system associated with the production of red blood cells (erythremia, erythrocytosis, etc.), changes in their shape (hemoglobinopathy, spherocytosis, sickle cell anemia, and others);
- prolonged fasting, dehydration;
- congenital or hereditary circulatory failure;
- violation of the nervous system: epilepsy, stress, neuroses, as well as mental disorders;
- regular intake of certain medications: calcium chloride, salicylates, preparations containing mercury.
Upon receipt of the results of ESR, you need to contact a therapist who will decipher them and refer them to a highly specialized doctor (infectious disease specialist, hematologist, oncologist, immunologist, and others).
Self-medication and an attempt to artificially stabilize the ESR level will not give results, but will blur the picture for further research and competent therapy.
How to prepare for the procedure
General analysis blood (within which ESR is detected) is carried out in the morning on an empty stomach. That is, between the last snack and the blood sampling procedure, about 8-10 hours should pass.
1-2 days before blood donation, it is necessary to give up alcohol, “heavy” food (fried, fatty, smoked), hot spices.
A couple of hours before the procedure, you should refrain from smoking (cigarettes, hookah, pipes, electronic cigarettes etc.).
Severe stress, psychological stress, physical activity (running, climbing stairs, carrying weights) can also affect the level of red blood cells. Immediately before the manipulations, you need to rest for 30-60 minutes.
You should also tell your doctor about all the drugs you take regularly or on demand. medicines. They are actively active substances may affect the result of the analysis.
Keep in mind that each laboratory uses different methods of testing ESR and units of measurement. Therefore, it is necessary to do an analysis, undergo further (repeated) examination and treatment in the same hospital.
Let's analyze a very common situation - ESR is above normal. What does it mean if the erythrocyte sedimentation rate is increased? And how quickly to recover!
An increase in the ESR value is not distinguished as an independent pathology. This indicator is a marker of inflammatory processes of various etiologies.
This is due to the fact that red blood cells are sensitive to the protein composition of the blood. It will change when specific protective proteins are released as a reaction to the penetration of an infection, the occurrence of malignant neoplasms, or the development of inflammatory autoimmune pathologies.
The price of analysis for private clinics starts from 100 rubles, the deadline 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 exist for correcting the state.
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 significant reason for a complete examination of the patient.
The erythrocyte sedimentation rate is always evaluated in combination with other indicators of the general and biochemical analysis blood.
In various sources, you can find a synonym for the term - the reaction of erythrocyte sedimentation. A person receives a referral from a general practitioner, pediatrician, gynecologist, infectious disease specialist, endocrinologist, hematologist or surgeon.
What is it - accelerated ESR syndrome?
Average statistics: for 5 - 10% of the human population, the indicator is at upper bound normal or above it for a long time. According to International classification diseases of the 10th revision (according to ICD 10), the accelerated ESR syndrome was assigned the code R70.0.
The syndrome may be a sign of the manifestation of another pathology or be an independent deviation.
The essence of the analysis
The principle of analysis is based on the ability of red blood cells to settle in a liquid medium of blood. An important condition for research is the creation of an environment that is as close to natural as possible. The blood to be tested must not clot and the erythrocytes must not break down (hemolysis). To do this, a special anticoagulant is added to the test tube, which prevents the clotting process. And the correct taking of the biomaterial guarantees the absence of hemolysis.
Why do red blood cells settle? The phenomenon of sedimentation is explained by the fact that red blood cells have a much greater weight than plasma. The speed of the process is determined by the level of their aggregation (sticking together). Clumped erythrocytes change the proportional ratio of the cell area to their volume. There is a decrease in the resistance of adherent cells to friction, in comparison with individual erythrocytes. The aggregate of adherent cells becomes heavier and settles faster.
Normally, human erythrocytes repel each other in the form of a negative electric charge of the same name. 2 factors contribute to their adhesion:
- the value of the surface potential of the cytoplasmic membrane;
- percentage of proteins in plasma.
A direct relationship has been established: the more protein components, the higher the probability of erythrocyte agglutination. 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 capillary graduated with a maximum of 100 mm. The analysis is performed from venous or capillary blood.
At the first stage, the anticoagulant solution is drawn up to a special mark "P", then it is poured onto a laboratory watch glass.
The second stage - the studied biomaterial is collected with the same capillary to the mark "K" twice. After that, the blood is poured onto the glass with an anticoagulant solution. The resulting ratio of biomaterial and anticoagulant 4:1.
The third stage - the biomaterial is carefully and thoroughly mixed with the solution and collected with 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.
The control measurement time depends on the objectives 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 standard. The date of development of the ESR method according to Westergren is considered to be 1926.
The sensitivity of this research method is higher than that of the Panchenkov method.
Biomaterial - blood taken from the cubital vein at the elbow. The ratio of anticoagulant and biomaterial 4 to 1 can be obtained in a similar way as in the previous method.
As a solution that prevents blood clotting, apply:
- 3.8% sodium citrate solution;
- ethylenediaminetetraacetic acid (EDTA) + saline.
For the study, specialized laboratory test tubes are needed, named after the scientist who developed the technique. The lumen of the test tube is 2.4 mm, an error of 0.1 mm is allowed. Graduation from 0 to 200 mm.
It is acceptable to use ungraded test tubes, in this case a rack with graduation is required.
The first control measurement is carried out after 1 hour, then - if necessary. Results are expressed in mm/h.
Differences in 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 methods is different. The ESR method according to Panchenkov is inferior in terms of sensitivity to changes in ESR to analysis according to Westergren.
In addition, a distinctive advantage of the Westergren method is the maximum scale of 200 mm. This is twice the compared method.
Important: in the final results, the laboratory must indicate the method used for each patient.
However, the results of both studies should correlate with each other. So, if the ESR according to Panchenkov is increased, then the Westergren method should also determine overestimated values.
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 methods have been developed that are performed by automatic analyzers. If it is impossible to take venous blood, the analyzers perform a study using the micromethod.
The use of mathematical algorithms can significantly reduce the time for issuing results. The data obtained are reduced to the standard values of the classical scales and are expressed in similar units.
What does it 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 of the indicator were detected.
So, increased ESR in the blood. What does this mean for 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. It does not matter the severity and stage of the disease: acute or chronic. The indicator is particularly sensitive to bacterial infection therefore, if during a cold a person has a sharp increase in ESR, the presence of bacterial complications should be suspected.
Autoimmune inflammatory processes are also accompanied by an upward deviation of the indicator. Therefore, first of all, it is these reasons that should be excluded.
If the patient complains of stomach pain, chronic diarrhea, rectal fissures, high temperature, loss of appetite and its erythrocyte sedimentation rate is increased, then diagnostics are carried out for specific intestinal diseases. For example, Crohn's disease or ulcerative colitis.
Heart disease
A sad trend of recent decades: myocardial infarction is increasingly common in patients under 40 years of age. Previously, the pathology occurred in people at least 60 years old. According to statistics, it occupies a leading position in the causes of death in the Russian Federation.
Pathology is characterized by acute myocardial necrosis against the background of obstruction. coronary arteries. Delay in hospitalization and provision of competent medical care leads to irreversible damage to the heart muscle.
The highest ESR level is recorded after 5-7 days. What is the result of a systemic inflammatory response of the human body.
It should be noted that the prognosis of the outcome depends on several factors:
- breadth of distribution 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 in women after 50 years of age is a reason for regular examinations to identify early signs diseases that have not yet manifested as clinical symptoms.
Oncology
Multiple myeloma is the formation of a malignant neoplasm from plasma cells. The disease is accompanied by excessive production of pathological proteins, which lead to accelerated aggregation of red blood cells. A typical feature is the formation of specific "coin columns" from erythrocytes.
Therefore, multiple myeloma is one of the reasons for the critical increase in ESR in men and women, the rates reach 50 - 80 mm / h. At the same time, the maximum norm for men: 15 - 20 mm / h, for women - 20 - 30 mm / h.
For malignant granuloma, the change in ESR is a typical clinical sign. The indicator is referred to as prognostic factors. If the criterion value is less than 50 mm/h, then a conclusion is made about a favorable prognosis.
A combination of factors: age over 40 years, ESR above 50 mm/h and damage to the lymph nodes makes it possible to classify the patient as a risk group. Even if at the time of the study he did not have symptoms of the disease, he should be regularly examined and monitored.
For oncology of various localization, the achievement of an indicator of extremely high values (more than 50 -80 mm / h) indicates metastases to neighboring 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, the combined decrease in iron-containing protein and an increase in ESR is interpreted as an abnormal sign that requires immediate identification of the cause.
Initially, the doctor will review the patient's medical record and compare the data obtained with previous indicators. The patient is then scheduled for repeat tests to reliably eliminate errors due to improper preparation and accidental substitution of samples from different patients.
In parallel with this, an analysis is carried out for fibrinogen, acute phase proteins and C-reactive protein. A study of blood serum proteins using electrophoresis is prescribed. To exclude multiple myeloma, a test is done 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 indicators of analyzes 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 should 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 his obligations 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, you should initially increase the level of iron and B vitamins. You can get them from lean meats, peanuts, cheese, beets, milk, sour cream, blackberries and prunes.
In case of detection of anemia, 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 taken into account that the therapy of the disease is a long process, going through the stages of selection and correction of the methods used.
Infections are treated antimicrobials. The drug itself is selected depending on the type of pathogen and its sensitivity.
The absence of positive dynamics in reducing the ESR value indicates the inefficiency of the selected methods.
Particular attention is paid to the treatment of oncological diseases. Here, the issue of stopping the spread of oncopathology and preventing relapses comes to the fore.
How to lower the ESR in the blood of women and men with folk remedies?
If a patient has a cold, then treatment with honey and onions can be supplemented. It is known that bee products have antimicrobial properties and slow down the development of pathogenic bacteria. In this case, 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 Orenburg State University with a degree in microbiology. Postgraduate graduate of FGBOU VO 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 in the additional professional program "Bacteriology".
Laureate of the All-Russian competition for the best scientific work in the nomination "Biological Sciences" in 2017.