Soe 4 mm hour. Not every case of elevated ESR is due to an ongoing disease.

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 because red blood cells sensitive to 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 carrying out complete examination patient.

The erythrocyte sedimentation rate is always evaluated in combination with other indicators of the general and biochemical blood tests.

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: 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 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 reacts especially sharply to a bacterial infection, therefore, if a person has a sharp increase in ESR during a cold, 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 is a reason for regular examinations in order to identify early signs diseases that have not yet manifested as clinical symptoms.

Oncology

Multiple myeloma - education 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.

That's why myeloma- 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 lesions lymph nodes puts the patient at risk. 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, ESR and hemoglobin are inversely related. The higher the hemoglobin, the lower the ESR. Therefore, the combined decrease in iron-containing protein and increase in ESR treated as an abnormal sign requiring immediate identification of the cause.

Initially, the doctor will review medical card patient and compare the obtained data 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 number 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 responsibility of the patient for his own health and does not relieve him of the obligation to maintain healthy lifestyle life, healthy 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 low-fat varieties meat, 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 assigned 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 all-Russian competition for the best scientific work in the nomination "Biological Sciences" 2017.

The erythrocyte sedimentation rate (ESR) has been used in laboratory practice since the late 19th and early 20th centuries. The Polish internist, pathologist and medical historian Edmund Bernacki proposed using erythrocyte sedimentation as a test. More than 120 years ago, E. Bernatsky published discussions about the possible mechanisms of the phenomenon and observations about the differences in the reaction when different types pathology. The analysis was called the erythrocyte sedimentation reaction (ROE) by the author. Often, when receiving the results of the analysis, the ESR is above the norm - what does this mean?

Even in the era of Galen, Hippocrates, doctors actively used bloodletting and noticed that the blood, after standing, “exfoliates”. The bottom layer is more dense and colored, and the top one is transparent and light. It was noticed that in patients the light layer is more pronounced than the dark one. But until the 20th century, the diagnostic value of ESR was not noted.

In 1918, at a congress in Stockholm, the Swedish hematologist R. Fareus reported a change in ESR during gestation, considering this analysis a pregnancy test. Later, ESR was considered an objective test for pathological processes in the body.

The essence of the ESR phenomenon is that erythrocytes form a precipitate under the influence of gravity. The rate of their settling depends on aggregation (sticking together). In various diseases, erythrocytes can form large conglomerates and then the ESR increases.

The formation of large conglomerates is due to an increase in:

• fibrinogen and globulin levels;
• plasma viscosity;
• blood cell size.

ESR is affected by:

• analysis method;
• age and gender characteristics.

To obtain discrete results, it is necessary to take into account the factors that affect the accuracy of the indicator. The table shows the reasons for the change in ESR in people, regardless of gender and age:

The influence of these factors distorts the result of the analysis and should be taken into account when conducting research.

ESR cannot claim the "title" of an analysis that gives an exhaustive result. When prescribing it and deciphering the indicators, the doctor must be aware of the diagnostic limitations of the analysis.

Among women

In women under the age of 60 years, the reference value (norm) of ESR is 2-12 mm / h. The indicator varies depending on the state and quantity of the main components of the blood, as well as on the activity of androgynous hormones. For representatives of both sexes, there are indicators of the norm of ESR in the blood in accordance with age. So, for women over 60, the norm is considered< 20 (30) мм/час.

A change in the level of hormones is also noted during the gestation period, so there is a special table of reference values ​​​​depending on the gestational age. Adaptive mechanisms in preparation for childbirth include changes in the blood. The norm of ESR in the second half of pregnancy is 40-50 mm/hour.

Since the reference values ​​​​are an average, and the upper limit of the norm is valid only for 95% of patients, then individual calculations of the norm can be done using the Tarelli, Westergren or simpler Miller formulas.

In children

The norm of ESR in the blood in children reflects the features of their development and improvement of various functions of body systems.

So, for example, ESR in the blood of newborns does not exceed 2 mm / hour, which is due to the peculiarities of the blood composition:

• high content of red blood cells (hematocrit);
• low amount of proteins and, in particular, globulins;
• high cholesterol (hypocholesterolemia);
• low acidosis.

With age, blood counts in children change, and so do ESR.

So, for example, the norm of ESR in children is:

• newborns: 1-7 days - 1-2 mm / hour; 8-14 days - 4-17 mm / hour; 2-6 months – 17-20 mm/hour;
• preschoolers - 1-8 mm / hour;
• adolescents: girls - 15-18 mm / hour; boys - 10-12 mm / hour.

In children, all indicators of the functioning of the systems are more labile (mobile) than in adults. Therefore, they are greatly influenced by external factors, for example, conditions environment. It has been established that in children and adolescents living in unfavorable conditions, blood characteristics differ from the average values ​​of the norm. So, in children living in high latitudes (European North), gender (sex) differences in the content of erythrocytes are increased.

Compared to adolescents from middle latitudes, they have significant differences in ESR:

• in girls - 6-8 mm / hour (against 5-6 mm / hour);
• in young men - 6-7 mm / hour (against 4-5 mm / hour).

In adolescents living in the conditions of the North, ESR readings are normally much higher than the normal ESR in the blood of children in middle latitudes. At the same time, the adaptation of girls to the conditions of high latitudes is more pronounced than that of boys.

In men

The norm of ESR in the blood in men is also subject to age-related metamorphoses:

Insignificant - by 1-2 units, an increase in the indicator compared to the norm may indicate the attenuation of the pathological process or a violation of the conditions for preparing for the analysis.

If the result deviates by 15-30 units, a slight inflammatory process, characteristic of colds, can be suspected.

An increase or decrease in the indicator by> 30 units indicates a serious process.

An indicator that differs from the norm by 60 or more units indicates severe violations states.

Since the ESR itself is uninformative and nonspecific (it cannot accurately indicate the nature and localization of the pathological process), it is prescribed in combination with other studies.

Table ESR norm in women by age

The chemical and physical composition of blood is influenced by many external and internal factors. Since the female body is more susceptible to changes, including hormonal changes, the fluctuations in ESR values ​​depending on age in women are more pronounced than in men.

Age-related changes occurring in a woman's body can be divided into 5 blocks:

1. Formation and development of the body.
2. Beginning of puberty.
3. Puberty is the childbearing period.
4. Beginning of menopause.
5. Climax.

Each of the blocks is characterized by its own ESR norm, and the period of puberty has a more detailed division. Below is presented in the form of a table the norm of ESR in women by age:

In addition to the factors listed above that affect ESR, in women, the result of the analysis increases with changes in the hormonal background, which is caused by:

• menstrual cycle;
• pregnancy;
• condition after childbirth and breastfeeding;
• taking oral contraceptives;
• hormone replacement therapy.

The level of ESR in women is significantly influenced by nutrition. Passion for diets of adolescents and young women leads to a deviation of ESR from the age norm. There are significant differences from the reference values ​​with an increase or decrease in body mass index.

ESR during pregnancy

Different indicators of ESR are observed in women at different gestational ages.:

• I trimester - ~ 13-21 mm / hour;
• II trimester - 25 mm / hour;
• III trimester - 30-45 mm / hour.

After childbirth, increased ESR persists for some time (3-4 weeks or more). An elevated ESR during pregnancy indicates that the fetus is developing.

If the level of ESR in a woman is above normal, what does this mean?

In pregnant women, the ESR level is higher than normal, what does this mean? Pregnancy is accompanied by genetically programmed, adaptive processes.

The degree of their severity depends on:

• gestational age;
• number of fruits
• individual reserve capabilities of a woman's body.

Even with a physiological pregnancy, researchers note the presence of signs of systemic inflammation syndrome.

With an increase in the gestational age, the ESR also increases, which is due to:

• a decrease in the number of red blood cells, due to an increase in the volume of blood plasma;
• an increase in the size of red blood cells;
• increased endogenous intoxication;
• activation of anti-inflammatory cytokines;
• decrease in the amount of total blood protein;
• an increase in the volume of fibrinogen in the blood and an increase in its viscosity.

These adaptive mechanisms lead to an acceleration of erythrocyte sedimentation.

Proteins are localized on the surface of red blood cells, leading to erythrocyte aggregation. In addition, the charge on the surface of the membrane of red blood cells also changes. If at the beginning of pregnancy potassium ions predominate, then by the II trimester their level decreases, and in the III trimester sodium ions prevail. By the end of pregnancy, the total accumulation of sodium ions reaches the limit values. A change in the charge of the membranes leads to the "sticking" of blood cells.

In addition, lipid metabolism changes in pregnant women. The amount of cholesterol, triglycerides and fatty acids, which are the material for the synthesis of steroids necessary for the formation of fetal tissues. All of these changes lead to an acceleration of ESR and are the physiological norm during pregnancy. Therefore, ESR during the gestational period loses its diagnostic value as an indicator of the inflammatory process.

But if the ESR significantly exceeds the upper limit of the norm, then this may indicate:

• inflammatory processes in the body;
• infections of the organs of the urogenital system;
• pyelonephritis caused by the mechanical impact of a growing fetus;
• late gestosis.

The study of blood parameters, including ESR, is carried out at least 4 times during the entire gestational period. The obtained results help to determine the presence of obstetric complications in early period and develop an adequate therapeutic correction of the condition.

Methods for determining ESR

Determination of ESR is carried out by several methods. On the territory of our country, the method proposed in 1924 by T.P. Panchenkov. And abroad they use the Westergren method, which in 1977 was recognized by the International Committee for Standardization in Hematology (ICSH) as a standard. The Westergren method was developed by the Australian hematologist Wintrobe. In Europe and Israel, the Wintrobe method is preferred, while in America the Wintrobe method is used. How do these methods differ?

ESR according to Panchenkov

This method has been used for over 90 years to determine the ESR. Capillary blood is used for research. It is diluted with sodium citrate and placed in a glass tube with an internal cavity diameter of 1 mm.

The simplicity and cheapness of the method does not compensate for its inherent shortcomings:

• the impossibility of standardizing the method due to the influence external factors(capillary purity, dilution errors, quality of sodium citrate);
• technical difficulties in obtaining capillary blood (hemolysis of blood when squeezing a finger);
• the impossibility of achieving an ideal inner surface and cleanliness of the capillary during repeated use.

The column used in the analysis has a length of 100 mm and is graduated with a step between the marks of 1 mm. Due to the small volume of blood in the capillary, it cannot be stored, which is a big disadvantage in screening. In addition, too many factors affect the accuracy of the result, which does not allow standardizing the method.

ESR according to Westergren

When determining ROE according to Westergren, whole venous blood is used. The length of the capillary is also different - it is 200 mm. In the zone of high ESR values, there are differences in the indicators according to Westergren and Panchenkov. So, for example, 70 mm/hour according to Panchenkov corresponds to approximately 100 mm/hour according to Westergren.

Despite the great accuracy of the Westergren method, it also has several disadvantages:

• inability to use blood for other tests, as blood for general analysis and ESR studies are prepared differently;
• the duration is 1 hour;
• high (18.3%) variability of results;
• the impossibility of automating the process.

Taking into account these shortcomings, Wintrobe improved Westergren's method.

ESR according to Wintrob

According to the Wintrobe method, blood is taken from a vein, but its amount is less than in the Westergren method, since the column is not 200 mm, but 100 mm. But this method greatly underestimates the result, as in the area low scores, as well as in the high region. So, for example, the table shows the corresponding analysis indicators blood ESR, the norm on different scales:

Therefore, when indicating the ESR indicators, it is necessary to mention the method by which the study was conducted.

If the methods of Panchenkov and Westergren are comparable in terms of results within the normal range, then the Vintrobe method gives indicators that are incomparable with the two previous methods.

In the 90s of the last century, automatic analyzers were developed that translate the result of multiple measurements of the optical density of a blood sample in accordance with the Westergreen scale. This method does not have the disadvantages listed above and the influence of the human factor is excluded.

Diseases in which there is an increased ESR in the blood

Currently, the diagnostic value of the method for determining the ESR in various pathological processes is being reviewed.

But for now, an increased ESR value is an indicator of diseases such as:

1. infections caused by various pathological agents:

• bacteria (tuberculosis, infections of the genitourinary system, diseases of the upper and lower respiratory tract);
• viruses (viral hepatitis);
• fungal infections that affect internal organs;

2. malignant diseases:

• malignant pathologies of the blood;
• malignant neoplasms of various organs;

3. rheumatological diseases (arteritis, rheumatism, rheumatoid arthritis, polymyalgia rheumatica);

4. injuries with suppuration and intoxication;

5. immune diseases and conditions;

6. systemic connective tissue diseases (systemic lupus erythematosus, systemic sclerosis, dermatomyositis);

7. kidney pathology (glomerulonephritis, pyelonephritis, kidney failure, ICD);

8. endocrine diseases ( diabetes, hyper- or hypofunction of the thyroid gland);

9. other conditions:

• inflammation: gastrointestinal tract, organs oral cavity, ENT organs, small pelvis, veins of the lower extremities;
• conditions after surgery;
• anemia;
• sarcoidosis;
• allergic reaction;
• epilepsy.

But elevated ESR is not always a symptom of a pathological process.

When can an increase in ESR be considered safe?

In addition to the physical and physiological factors listed above that affect the rate of ESR, the indicators can be distorted by:

• human factor (error or incompetence of the laboratory assistant);
• the use of low-quality reagents;
• non-compliance with the rules of preparation for analysis:
• eating before blood sampling;
• intense physical activity;
• taking hormonal or other drugs;
• prolonged violation of the food and drinking regimen (starvation, strict diets, dehydration);
• changes in the gas and lipid composition of the blood.

In children, increased ESR is noted with:

• lack of vitamins;
• teething;
• power change, for example, when switching from breastfeeding for food;
• malnutrition.

These factors are easy to correct and they do not have a pathogenic effect on the body.

How to lower ESR in the blood?

In order to reduce the increased ESR, it is necessary to establish the cause, detect and cure the pathology. In the absence of symptoms of the disease, it does not make sense to reduce ESR, studies are prescribed that are repeated after a certain period of time. To regularly monitor the level of ESR in the blood, it is necessary to undergo annual studies, and with an increase in the indicator, additional tests and an in-depth study are prescribed.

A blood test for ESR - erythrocyte sedimentation rate - is mandatory in the process of initial diagnosis.

This study only helps to determine the further course of medical actions. After all, whatever the results of the analysis, they are not a reliable sign of pathologies. Deviation of ESR from the norm only indirectly indicates that an inflammatory process may occur in the body or an infection develops.

The value of research on ESR

The results of the analysis are very individual. Their upward trend is due to many reasons. There is no specific disease in which ESR increases.

This indicator is considered general, non-specific, since it does not contain an answer to the question of whether a person is healthy or sick.

But studying the results of the study:

• contributes to the accelerated and timely conduct of additional tests;
• in combination with the data of other analyzes allows you to objectively assess the state of the body;
• makes it possible to make forecasts for the short term;
• in dynamics indicates the course of the disease and how correctly the therapeutic methods are chosen. Approximation of ESR to the norm certifies that the medicines and procedures prescribed by the doctor are successful and the patient is recovering.

Regulatory ESR values depends on the person's age and gender.

The average for men is in the range from 8 to 12 units (millimeters per hour), for women - from 3 to 20.

With age, ESR grows and in respectable years reaches 50 units.

Elevated ESR: growth rates

For correct diagnosis, it matters how much the ESR exceeds the norm. Depending on this, four degrees of deviations can be distinguished:

• First, which is characterized by a slight increase in ESR. The rest of the blood counts remain normal.
• Second- the results of the analysis recorded an excess of ESR by 15–29 units. This signals that there is an infectious process in the body, which so far has little effect on it. general state. Such a situation is typical for colds. If they are treated, then the ESR will return to normal in a couple of weeks.
• Third- the increase in ESR is more than 30 units. Such an increase in the indicator is considered significant and serious. As a rule, the size of the ESR indicates the development of dangerous inflammatory or necrotic processes. It can take several months to heal the disease.
• Fourth- ESR rises by 60 units or more. This situation reflects an extremely difficult and life-threatening condition of the body. Immediate and thorough treatment is required.

Causes of increased ESR

An increase in ESR may be the result of the development of one or even several diseases at the same time. They can be classified like this:

• Viral, bacterial and fungal infections. They can be relatively mild, such as SARS or acute respiratory infections. But often a serious illness develops, in which the ESR exceeds the norm several times and reaches 100 mm / h. For example:
  • viral hepatitis;
  • flu;
  • pyelonephritis;
  • pneumonia;
  • bronchitis.
• Neoplasms, both benign and malignant. ESR increases significantly, but the level of leukocytes may remain normal.

  Video recipe for the occasion:
  

  An increase in the index is more typical in the presence of single peripheral formations. Less commonly, it occurs when tumors of the lymphoid and hematopoietic tissue are present.

• Rheumatological diseases:
  • true rheumatism;
  • arthritis and arthrosis;
  • ankylosing spondylitis (Bekhterev's disease);
  • all systemic vasculitis;
  • diffuse connective tissue transformation: Sjögren's disease, Sharp's syndrome, systemic scleroderma and lupus erythematosus, polymyositis.
• Kidney disease and urinary tract dysfunction:
  • hydronephrosis;
  • urolithiasis disease;
  • nephroptosis (omission of the kidney);
  • pyelonephritis (more common in women);
  • glomerulonephritis.
• Blood diseases:
  • hemoglobinopathy, namely thalassemia and sickle cell anemia;
  • anisocytosis.
• The most severe conditions that are accompanied by an increase in blood viscosity:
  • intestinal obstruction;
  • diarrhea and vomiting;
  • food poisoning.

In almost 20% of cases, the cause of excess growth of ESR is poisoning of the body and rheumatological diseases. These pathologies lead to the fact that the blood becomes thicker and more viscous, and red cells begin to settle at a faster rate.

The greatest increase in ESR occurs when infectious processes are present and develop in the body. The value of the indicator does not increase immediately, but only a day or two after the onset of the disease. When the body recovers, ESR decreases slowly. It will take a month and a half before the indicator returns to normal.

An increase in ESR also occurs after surgery. It can also accompany post-shock states.

False increase in ESR

Exceeding the ESR norm is possible without the presence of ailments in the body. There are a number of natural causes:

• taking medications containing hormones;
• allergic reactions;
• excessive consumption of vitamin complexes, especially vitamin A;
• errors in the diet;
• individual characteristics of the body. Statistics show that almost 5% of the world's population has an accelerated red blood cell sedimentation reaction;
• bearing a child. In pregnant women, ESR can grow three or more times, which is not considered a pathology;
• insufficient absorption of iron by the body, its deficiency;
• age from 4 to 12 years. During this period, especially in boys, an increase in ESR is possible, associated with the development and formation of the body. There are no infections or inflammations.

The growth of ESR in excess of the norm in some cases accompanies certain chronic conditions. These include:

• elevated blood cholesterol levels;
• recent vaccination against hepatitis;

A high degree of obesity also causes red blood cells to drop faster than they should.

Features of increasing ESR in men and women

A slight increase in ESR was noted in approximately eight percent of men. And it is not considered a deviation from the norm. The explanation lies in individual features organism of a particular person. The value of the indicator is influenced by the way of life and the presence bad habits like smoking and drinking alcohol.

AT female body increased ESR can be due to relatively safe reasons:

• the beginning of critical days;
• reception hormonal drugs, in particular contraceptives;
• eating habits: following a low-calorie diet or overeating, consuming fatty foods shortly before a blood test;
• pregnancy.

Increased ESR during pregnancy

During pregnancy, the processes in the female body occur in a special way. somewhat modified and protein composition blood, which is reflected in the ESR.

The indicator can jump up to 45 units, and this will not indicate the manifestation of diseases.

ESR begins to gradually increase as early as the tenth week of pregnancy. Highest value, as a rule, is fixed in the third trimester.

Almost a month after delivery, the ESR is also overestimated. The cause is anemia, which developed during the period of bearing the crumbs. It provokes a significant blood thinning and increases the rate of red cell sedimentation.

The size of the ESR is affected by the complexion of a woman. For thinner expectant mothers, the indicator rises to a greater extent than for puffy ladies.

A month or a half after the birth of the baby, the ESR quickly returns to normal.

But even such objective processes should not be ignored. Only a doctor can determine how normal the pregnancy is and whether everything is in order with the expectant mother.

Features of increasing ESR in children

The causes of increased ESR in babies are not much different from those that are typical for adults. Most often, this symptom manifests itself as a result of:

• infectious diseases, including chronic diseases;
• intoxication;
• allergic reactions;
• helminthiasis;
• metabolic disorders;
• injuries to limbs and other parts of the body.

Infectious-inflammatory processes in children manifest themselves not only by an increase in ESR. Other indicators, which are determined using a general blood test, also change. The general condition of the baby worsens.

A slight increase in ESR can be explained by such non-dangerous factors as:

• violation of the diet by a nursing mother: there is an excess of food with a significant content of fat in the diet;
• taking oral medications;
• the baby is teething;
• there is a lack of vitamins in the body.

Parents whose children have an indicator above the established norm are contraindicated in panic. It is necessary to carefully examine the child and establish the causes. Successful treatment of the underlying ailment will help normalize the ESR in a month or a month and a half.

Treatment of elevated ESR

An elevated level of ESR in itself is not a pathology, but only suggests the development of a disease in the body. Therefore, bringing the indicator back to normal is possible only after the treatment of the underlying disease.

In some cases, there is no need to lower it. For example, ESR will not return to normal until:

• the wound will heal or the broken bone will not heal;
• the course of taking a certain drug will come to an end;
• a child is born in the womb.

If ESR is elevated during pregnancy, it is necessary to think about how to prevent anemia or reduce its consequences.

Women in an “interesting” position need to take a responsible attitude to the diet and follow all the recommendations prescribed by the gynecologist. Your doctor may prescribe safe iron supplements or special dietary supplements.

In many cases, it is possible to lower the ESR to the limits of the norm only by eliminating the inflammatory process. To determine its cause, a general blood test is not enough, a deeper study of the patient's body condition is necessary. The doctor-therapist can appoint it. It is he who knows all the examination protocols and treatment tactics.

Medicines should be taken only on the recommendation of a doctor. Self-selected medicines, most likely, will not bring the desired result, but will only have a negative effect on the internal organs and lead to unnecessary spending.

When an elevated ESR is accompanied by a slight temperature, you can try to help the body with herbs and natural products.

In the piggy bank traditional medicine there are many useful recipes. In one of them, it is recommended to cook the most ordinary beets. Properly prepared, it can lower the ESR in ten days.

It is necessary to choose three small beets, wash them thoroughly and do not remove the tails. Then the vegetables are boiled for about three hours. The resulting broth is filtered and stored in a cold place. It is enough to drink 50 grams of beet liquid per day. The decoction is taken in the morning on an empty stomach.

Juice squeezed from beets is also a good blood cleanser. It is necessary to drink it before going to bed for half a glass. Ten days of this intake will help improve blood circulation.

An effective remedy is one that contains lemon juice and garlic. One hundred grams of the latter must be crushed. Then mix the resulting slurry with the juice of six to seven lemons. Put the drink in the refrigerator and take a teaspoon in the evening, diluted with a glass of boiled water.

Freshly squeezed citrus juices are also useful. It is advisable to add a teaspoon of honey to them.

It happens that the examination did not reveal serious pathologies, and the ESR does not decrease. In this case, you need to periodically conduct preventive examinations. When negative symptoms appear, you should not let everything take its course, but seek advice. Preventive measures always give positive results and help to maintain health for many years.

You feel normal, nothing causes serious concern ... And suddenly, when you take another blood test, it turns out that you have a changed erythrocyte sedimentation rate (ESR). Should I be worried? How important is the value of this indicator and what should be done in such a situation? Let's figure it out together.

ESR analysis: what is it

ESR (ROE, ESR) - erythrocyte sedimentation rate - is a very important characteristic that can indirectly indicate inflammatory and pathological processes in the body, including those occurring in a latent form. The ESR index is influenced by a number of factors, including: infectious diseases, fever, chronic inflammation. Upon receipt of an ESR analysis result that does not meet the standard values, the doctor will always prescribe an additional examination to identify the cause of the deviation.

To determine the level of ESR, an anticoagulant (a substance that prevents clotting) is added to the blood taken for analysis. Then this composition for one hour is placed in a vertically mounted container. The specific gravity of erythrocytes is higher than the specific gravity of plasma. That is why, under the influence of gravity, erythrocytes settle to the bottom. The blood is divided into 2 layers. Plasma remains in the upper one, and erythrocytes accumulate in the lower one. After that, the height of the top layer is measured. The number corresponding to the border between erythrocytes and plasma on the test tube scale will be the erythrocyte sedimentation rate, measured in millimeters per hour.

Why is a blood test important?
Blood consists of plasma and formed elements: erythrocytes, leukocytes and platelets, the balance of which reflects the state of the patient's body. Many pathological processes develop asymptomatically, so timely analysis often helps to identify a number of diseases on the early stages, which allows you to start treating them on time and avoid many problems.

When is an erythrocyte sedimentation rate test ordered?

Determination of ESR is necessary in the following situations:

• for diagnostics and preventive examinations;
• to monitor the patient's condition during treatment;
• with infectious diseases;
• at inflammatory diseases;
• with autoimmune disorders;
• in the presence of ongoing oncological processes in the body.

Preparing and conducting a blood sampling procedure

An ESR analysis does not require special preparation, but before donating blood, you need to follow a few simple rules.

Firstly, one day before the analysis, you should refrain from drinking alcohol, and 40-60 minutes from smoking. Secondly, you can not eat 4-5 hours before the study, you can only drink non-carbonated water. Thirdly, if you are taking medication, check with your doctor, as it is advisable to stop taking it before the study. medical preparations. And most importantly - try to avoid any emotional and physical overload before the test.

Analysis Methodology

The determination of the erythrocyte sedimentation rate is carried out in one of two ways: by the Panchenkov method or by the Westergren method.

Panchenkov's method

A 5% solution of sodium citrate (anticoagulant) is poured into a capillary divided into 100 divisions up to the “P” mark. After that, the capillary is filled with blood (the biomaterial is taken from the finger) up to the “K” mark. The contents of the vessel are mixed, then placed strictly vertically. ESR readings are taken after an hour.

Westergren method

For analysis according to Westergren, blood from a vein is needed. It is mixed with sodium citrate 3.8% in a ratio of 4:1. Another option: blood from a vein is mixed with ethylenediaminetetraacetic acid (EDTA), and then diluted with the same sodium citrate or saline in a 4:1 ratio. The analysis is carried out in special tubes with a scale of 200 mm. ESR is determined in an hour.

This method is recognized worldwide. The fundamental difference is in the type of test tubes and the scale used. The results of both methods coincide in standard values. However, the Westergren method is more sensitive to increased erythrocyte sedimentation rate and in this situation the results will be more accurate than the Panchenkov method.

Deciphering the ESR analysis

The results of the erythrocyte sedimentation rate test are usually prepared within one working day, not counting the day of blood donation. However, commercial medical centers Those who have their own laboratory can provide the test result more quickly - within two hours after taking the biomaterial.

So, you received a form with the result of the analysis for ESR. On the left you will see this abbreviation (either ROE or ESR) and on the right your result in mm/h. To find out how it corresponds to the norm, you should correlate it with the reference (average) values ​​\u200b\u200bcorresponding to your age and gender. ESR norm indicators for men and women different ages look like this:

The ESR norm in women is slightly higher than in men. Also, the indicator changes during pregnancy - this is natural process. The value may also depend on the time of day. The maximum value of ESR is usually reached around noon.

ESR increased

An increase in the erythrocyte sedimentation rate can be caused by the most different reasons. Consider the main ones:

• Infectious diseases both acute (bacterial) and chronic.
• Inflammatory processes occurring in various organs and tissues.
• Connective tissue diseases (rheumatoid arthritis, lupus erythematosus, systemic scleroderma, vasculitis).
• Oncological diseases of various localizations.
• Myocardial infarction (damage to the heart muscle occurs, this entails a systemic inflammatory response, resulting in an increased ESR). After a heart attack, ESR peaks about a week later.
• anemia. In these diseases, there is a decrease in the number of erythrocytes and an acceleration of their sedimentation rate.
• Burns, injuries.
• Amyloidosis is a disease associated with the accumulation of abnormal protein in tissues.

However, elevated ESR can also be observed in healthy people. For example, in women during menstruation and pregnancy. Also, the result of the analysis is influenced by some medications e.g. oral contraceptives, theophylline, synthesized vitamin A.

note
ESR can be increased in people who are overweight. This is due increased level cholesterol in their blood.

ESR lowered

A decrease in the reaction of the erythrocyte sedimentation rate is often noted by doctors in diseases such as erythrocytosis, leukocytosis, DIC, and hepatitis. Also, ESR decreases with polycythemia (an increase in the number of red blood cells) and conditions leading to it, such as chronic heart failure or lung disease.

Another reason for the decrease in ESR is the pathology in which changes in the shape of red blood cells occur. It can be sickle cell anemia or hereditary spherocytosis. These diseases make it difficult for erythrocytes to settle.

In addition, ESR can be lowered in "radical" vegetarians, that is, those who do not eat not only meat, but also any food of animal origin.

It should be remembered that the ESR test is one of the non-specific laboratory tests blood. An increase in the erythrocyte sedimentation rate is observed at the most various diseases. In addition, this indicator can be increased under certain circumstances and in healthy people. Therefore, based on the results of this study alone, a diagnosis cannot be made. To detail the latter, it is recommended to pass additional tests, including quantitative analysis. C-reactive protein, leukocyte formula, rheumatoid factor.

Wednesday, 03/28/2018

Editorial opinion

A high erythrocyte sedimentation rate is not a cause for panic. However, to avoid unnecessary anxiety, it is better to consult a doctor and take tests to find out the cause of the deviation from the norm and, if necessary, take action. Careful attention to your health should be mandatory for each of us.