What is COE measured in? ESR (erythrocyte sedimentation rate): concept, norm and deviations - why it rises and falls

In this article we will talk about such a blood test as the erythrocyte sedimentation rate. Consider the norm of ESR in women by age in the table, explain the reasons for the deviations and tell you how to normalize its level.

What is SOE?

ESR is the erythrocyte sedimentation rate, the analysis of the erythrocyte sedimentation reaction (ROE) is also used.

The erythrocyte sedimentation rate is one of the indicators by which you can find out about the course of inflammation, which is diverse in origin.

The erythrocyte sedimentation rate (ESR) is a measure of how quickly erythrocytes (red blood cells) settle to the bottom of a glass tube containing a blood sample. The test actually measures the rate of fall (sedimentation) of red blood cells in a blood sample that has been placed in a tall, thin vertical tube.

How is ESR determined?

In order to find out this indicator, an anticoagulant (an element that prevents clotting) is injected into the blood for analysis and it is placed in a test tube placed in a vertical position for 60 minutes. Plasma is lighter than erythrocytes, for this reason they settle at the bottom of the tube under the influence of gravity.

The blood will be divided into two parts: red blood cells will remain at the bottom, and plasma will remain at the top. After 1 hour, the rate at which the erythrocytes descend along the height of the part of the plasma that has appeared is observed in millimeters. The number on the scale of the test tube, located at the boundary between the two parts, is called the settling rate, measured in millimeters per hour.

With diseases in the blood, the level of fibrinogen increases (this is one of the proteins acute stage the process of inflammation) and globulins (defense elements that appear in the blood to fight elements that cause inflammation - microbes, viruses), which can lead to agglutination and precipitation of red blood cells and an increase in the indicator.

As a rule, the ESR begins to rise a day or two after the inflammation has begun, and it becomes much higher somewhere in the second week of the disease, sometimes the peak occurs at the time of the cure for the disease. This is due to the fact that the body needs time to produce antibodies in the required amount. Measuring an indicator several times will provide more information than measuring a given indicator just once.

Various methods are used to determine the level of the indicator. The most common in Russia remains Panchenkov's method. At the world level, the most common measurement method is Westergren analysis.

These methods can be distinguished from each other by different test tubes and a result scale. The range of the norm for these methods is the same, but the second method is more sensitive to an increase in the index, and in the range of values ​​above the norm, the results taken by the second method are greater than the results that were found out by the Panchenkov method.

The norm of ESR in the blood in women by age (table)

Reference (permissible) values ​​are selected individually, taking into account the age, stage or duration of pregnancy. It is up to each woman to interpret the information received from the analysis. However, the findings are of no diagnostic value without a complete history. You should provide a transcript of the results and clarification of the diagnosis to the attending physician.

The table below summarizes the ESR indicators characteristic of a healthy woman.

Reasons for increasing and decreasing ESR

ESR is determined by a large number of factors.

During the period of bearing a child, women change protein composition blood, which leads to an increase in the rate at a given time.

Level fluctuation is allowed in different periods days, the highest level of ESR is typical for the day.

If there is infection or inflammation in the acute stage, fluctuations in ESR can be seen a day after the onset elevated temperature and the appearance of a large number of leukocytes.

If the inflammation is chronic, fluctuations in the index occur due to an increase in the concentration of specific proteins and antibodies. The viscosity of the blood and the total number of erythrocytes also have a great influence on the speed. For example, when there is a serious decrease in blood viscosity, an increase in the indicator may well occur, and in diseases associated with an increase in red blood cells, on the contrary, the viscosity increases and the sedimentation rate decreases.

ESR increases with the following problems and diseases:

• disease respiratory tract(ORZ,);
• inflammation of the bladder, as a result of infection;
• non-specific inflammation with a primary lesion of the pyelocaliceal system of the kidneys;
• infection (, infective endocarditis, (blood poisoning));
• giant cell arteritis;
• systemic ;
• kawasaki syndrome ;
• inflammatory;
• renal failure,;
• certain types of cancer;
• rheumatic and bacterial inflammation of the inner lining of the heart;
• nonspecific, brucellosis, gonorrheal polyarthritis;
• poisoning;
• injuries, bruises, sprains;
• obesity;
• prolonged bleeding;
• , etc.

ESR decreases with the following problems and diseases:

• diseases of the cardiovascular system;
• simultaneous malfunctions of the liver and biliary tract;
• starvation and lack of minerals and vitamins in the body;
• with prolonged nutrition of plant and dairy foods with the rejection of meat foods of animal origin;
• the use of liquids in large quantities;
• use of steroid hormones
• (shift of the acid-base balance of the body in the direction of increasing acidity).
• frequent use of acetylsalicylic acid tablets.

In most cases, deviations in ESR indicate inflammation in the body. Diseases associated with an increase in blood cells, changes in the composition of blood proteins. However, an ESR blood test is not used alone to diagnose any of the above conditions. The doctor usually combines the analysis with other studies.

ESR is considered a non-specific test because high readings often indicate the presence of inflammation, but do not tell doctors where the inflammation is located in the body or what is causing the disease process. Conditions other than inflammation can affect the erythrocyte sedimentation response. For this reason, ESR is commonly used in conjunction with other studies. Often carried out with analysis for.

During pregnancy

When carrying a fetus, the erythrocyte sedimentation rate in women is examined 4 times:

• at the beginning after fertilization up to the 4th month;
• at 20-21 weeks of gestation;
• at 28-30 weeks;
• before the end of pregnancy (childbirth).

Due to hormonal changes that last throughout the entire period of development in the body of the fetus, the level of ESR in a woman changes significantly during 9 months of pregnancy, and may also change for some time after childbirth.

• 1 trimester of pregnancy. The norm of ESR in the blood in the first 30 days of pregnancy is unstable: depending on the build, body shape and individual features the indicator can be low (12 mm/h) or high (up to 40 mm/h).
• 2nd trimester of pregnancy. At this time, the condition of expectant mothers normalizes and the rate of erythrocyte sedimentation becomes 20-30 mm / h.
• 3rd trimester of pregnancy. The last terms of gestation are characterized by a significant increase in the permissible norm of ESR - from 25 to 40 mm / h. Such sharp indicators indicate the rapid development of the embryo in the womb and does not require therapy.

After childbirth, ESR in women remains high, because as a result of labor pains, a woman can lose a lot of blood. For a couple of months after the birth of a baby, ESR can reach 35 mm / h. When hormonal processes are rebuilt back to normal, the ESR level in a woman decreases to 0-20 mm / h.

During menopause in women

Age-related restructuring in a woman's body is characterized by strong hormonal disruptions that affects plasma and blood cells. During the norm of ESR in the blood, it mainly increases, and can reach up to 50 mm / h.

In women after 50-60 years, the level of erythrocyte sedimentation can be quite elevated (up to 30 mm / h), which is the norm, if other blood parameters do not exceed acceptable normal values.

However, after menopause ESR in the blood in women more than 50 mm / h may indicate the following pathologies:

• hyperfunction thyroid gland(hyperthyroidism, occurring in 40% of women after 45 years;
• cancer of any organ;
• rheumatism;
• STD;
• pathology of the urinary system.

A reduced level of ESR during menopause and during postmenstrual syndrome always indicates pathological processes in a woman's body.

Preparation for the delivery of analyzes for ESR

There is no special preparation for testing for the erythrocyte sedimentation reaction. There are a number of drugs that can affect the result of the tests:

• androgens, in particular testosterone;
• estrogens;
• sodium salicylate and others medicines, analgesics and antipyretics from the group of salicylic acid derivatives;
• valproic acid;
• divalproex sodium;
• phenothiazines;
• prednisone.

Tell your doctor if you have recently used anything on the list.

How is the procedure for taking blood

In adults, blood is taken from a vein in the arm. In the case of infants, blood can be taken by pricking the heel with a small needle (lancet). If blood is taken from a vein, the surface of the skin is cleaned with an antiseptic, and an elastic band (tourniquet) is placed around the arm to induce pressure. The needle is then inserted into a vein (usually at the level of the elbow on inside hands or on the back of the hand), and take blood, which is collected in a test tube or syringe.

After the procedure, the gum is removed. As soon as enough blood is collected for the study, the needle is removed, the area is covered with a cotton pad or cotton swab with alcohol to stop the bleeding. The collection of blood for this test takes only a few minutes.

Complications when taking blood

Any of the methods of drawing blood (from the heel or from the vein) will cause temporary discomfort, and the only thing you will feel is a prick. Subsequently, it is possible that a small bruise will form, which should disappear in a few days.

What to do if ESR deviated from the norm?

If there are no complaints other than a change in ESR, or if the patient has recently had infectious diseases, the doctor will again conduct ESR studies in a week. If the erythrocyte sedimentation rate returns to the normal range during the next test, it is enough to wait and perform a new test.

However, if the erythrocyte sedimentation rate is still elevated or other symptoms appear, additional examinations (such as LDH, transaminases, creatinine,) are necessary. If necessary, the doctor also conducts an ultrasound scan. abdominal cavity or a chest x-ray.

How to reduce the level of ESR

If the cause of the elevated ESR is infectious or inflammatory disease, antibiotics and anti-inflammatory drugs will help reduce rates.

If the deviations are caused by pregnancy, the ESR will return to normal after the birth of the child.

In some cases folk remedies used to relieve inflammation. Particularly popular in acute infectious diseases are medicines based on herbs, garlic, onion, lemon, beetroot, honey(and others bee products, for example: ). Decoctions, infusions, teas are prepared from herbs. Most effective mother and stepmother, chamomile, linden flower, raspberry.

For a long time, beetroot products have been used to treat acute infections. To prepare a healing drink, several beets must be boiled for 3 hours over low heat, then cooled, strained and drink 50 ml of the drink. You can squeeze freshly squeezed beetroot juice and take 50g per day for 10 days. Another option is to replace the juice with raw beets, grated.

You can also use all citrus fruits: oranges, grapefruits, lemon. Tea with raspberry and lime is very useful.

Nutrition with elevated ESR

The level of ESR and lymphocytes increases as a result of inflammation. There are a number of products that can reduce inflammation and normalize ESR:

• omega 3 and 6 fatty acid found in fatty fish oil will reduce inflammation in the body;
• Olive oil contains antioxidants called polyphenols that will help reduce or prevent inflammation.
• also foods high in antioxidants (spinach, yogurt, nuts, carrot-carrot juice).

Avoid:

• foods high in saturated or trans fats;
• Sahara.

Conclusion

The erythrocyte sedimentation rate is a useful, simple and inexpensive laboratory test that, despite its centuries of performance, continues to be a valuable tool in medical work, especially in rheumatology, hematology and other fields.

Its indication and interpretation require reasonable thinking to underestimate or overestimate the result, always subject to a number of factors specific to pathology and evolution. various types patients.

What else is called this indicator: erythrocyte sedimentation reaction, ROE, erythrocyte sedimentation rate.

Additional Information

What do red blood cells say to a doctor?

90 percent of all blood cells are red blood cells. Their color comes from the red blood pigment (hemoglobin), an iron-containing protein that can bind oxygen and, in particular, carbon dioxide.

Diagnosis of anemia

The concentration of red blood pigment can be determined by a blood sample. In addition, the number of red blood cells is determined. If both sizes are reduced, this indicates anemia. The causes may be blood loss, a violation of the formation of red blood cells. If the doctor detects anemia, he will begin further research to identify the causes of the disorder. Common cause lack of iron.

More about the Author.

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

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

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

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

Red blood cells have a feature - under certain conditions, they "stick together" together, forming cell complexes. Since their mass is much greater than the mass of individual erythrocytes, they settle to the bottom of the tube faster. With the inflammatory process occurring in the body, the rate of erythrocyte association increases, or, conversely, decreases. Accordingly, the ESR increases or decreases.

The accuracy of blood testing depends on the following factors:

Proper preparation for the analysis;

Qualifications of the laboratory assistant conducting the study;

The quality of the reagents used.

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

Indications for the determination of ESR - control over the appearance and intensity of the inflammatory process in various diseases and in their prevention. Deviations from the norm indicate the need for biochemical analysis blood to check the level of certain proteins. Based on one test for ESR, it is not possible to make a specific diagnosis.

The analysis takes 5 to 10 minutes. Before you donate blood for the determination of ESR, you can not eat for 4 hours. This completes the preparation for blood donation.

Sequence of capillary blood sampling:

The third or fourth finger of the left hand is wiped with alcohol.

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

Remove the drop of blood that has come out with a sterile napkin.

Biomaterial sampling is carried out.

Disinfect the puncture site.

A cotton swab moistened with ether is applied to the fingertip, they are asked to press the finger to the palm to stop the bleeding as soon as possible.

Sequence of venous blood sampling:

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

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

Collect the required amount of blood in a test tube.

Remove the needle from the vein.

The puncture site is disinfected with cotton wool and alcohol.

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

Blood taken for analysis is examined to determine the ESR.

The test tube containing the biomaterial with the anticoagulant is placed in a vertical position. After some time, the blood will be divided into fractions - at the bottom there will be red blood cells, at the top there will be a transparent plasma with a yellowish tinge.

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

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

The procedure for determining the ESR according to Panchenkov:

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

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

The tube is placed in a Panchenkov stand.

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

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

ESR analysis methods

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

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

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

Westergren method

A study using this method is the international standard for measuring ESR. For its implementation, a more accurate scale of 200 divisions, graduated in millimeters, is used.

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

The gender and age of the subjects affect the ESR values ​​taken as the norm.

In healthy newborns - 1-2 mm / hour. The reasons for the deviation from the normative indicators are acidosis, hypercholesterolemia, high hematocrit;

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

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

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

In women, it is 2-15 mm/hour, these values ​​vary depending on the level of androgen, from the 4th month of pregnancy, the soy increases, reaching up to 55 mm/hour by childbirth, after childbirth it returns to normal in 3 weeks. The reason for the increase in ESR is an increased level of plasma volume in pregnant women, globulins.

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

The use of contraceptives, high molecular weight dextrans;

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

Increased metabolism caused by exercise.

Change in ESR depending on age and gender

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

Table of ESR norms in women by age

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

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

The values ​​of the norm for a woman fluctuate depending on the changes in her body.

Indications for a blood test for ESR in women:

Lack of appetite,

Pain in the neck, shoulders, headache,

Pain in the organs small pelvis,

Unreasonable weight loss.

The norm of ESR in pregnant women, depending on the completeness

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

The norm of ESR in the blood in children

ESR above normal - what does it mean?

The main reasons that accelerate the rate of erythrocyte sedimentation are changes in the composition of the blood and its physicochemical parameters. Plasma proteins agglomerins are responsible for the implementation of erythrocyte sedimentation.

Reasons for an increase in ESR:

Infectious diseases that provoke inflammatory processes - syphilis, tuberculosis, rheumatism, blood poisoning. By ESR results make a conclusion about the stage of the inflammatory process, control the effectiveness of treatment. In bacterial infections, ESR values ​​are higher than in diseases caused by viruses.

Endocrine diseases - thyrotoxicosis,.

Rheumatoid polyarthritis.

Pathologies of the liver, intestines, pancreas, kidneys.

Intoxication with lead, arsenic.

Malignant lesions.

Hematological pathologies - anemia, myeloma, Hodgkin's disease.

Injuries, fractures, conditions after operations.

High cholesterol.

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

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

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

Insufficient level of fibrinogen;

Reactive erythrocytosis;

chronic insufficiency blood circulation;

In men, ESR below the norm is almost impossible to notice. Moreover, this indicator does not of great importance for diagnostics. Symptoms of a decrease in ESR are hyperthermia, fever. They may be harbingers infectious disease or an inflammatory process or signs of changes in hematological characteristics.

In order to normalize the indicators of laboratory testing of ESR, the cause of such changes should be found. Most likely, you will have to undergo a course of treatment prescribed by a doctor, additional laboratory and instrumental research. Accurate diagnosis and optimal therapy of the disease will help to normalize the ESR. For adults, this will take 2-4 weeks, for children - up to one and a half months.

At iron deficiency anemia the ESR reaction will return to normal with the use of a sufficient amount of foods containing iron and protein. If the cause of the deviation from the norm was a passion for diets, fasting, or physiological conditions such as pregnancy, breast-feeding, menstruation, ESR will return to normal after the normalization of the state of health.

At elevated level ESR should first be excluded natural physiological causes: elderly age in women and men, menstruation, pregnancy, postpartum period in women.

Attention! 5% of the inhabitants of the Earth have an innate feature - their ESR indicators differ from the norm without any reason and pathological processes.

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

• Inflammatory process,

  malignant tumors,

  kidney disease,

  Acute or chronic infections,

  myocardial infarction,

  burns, injuries,

  Condition after surgery.

In addition, the erythrocyte sedimentation reaction can be affected by therapy with the use of estrogen, glucocorticosteroids.

Reasons for a decrease in the erythrocyte sedimentation rate:

Violation of water-salt metabolism;

Progressive myodystrophy;

1st and 2nd trimester of pregnancy;

taking corticosteroids;

Vegetarian diet;

Starvation.

In case of deviation from the norm, you should consult a doctor to find out the cause of this health condition.

Editorial opinion

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

About the doctor: From 2010 to 2016 practicing physician of the therapeutic hospital of the central medical unit No. 21, the city of Elektrostal. Since 2016, she has been working at the diagnostic center No. 3.

The results of a blood test, when the value of the erythrocyte sedimentation rate is increased, will frighten the patient, especially in the absence of signs of the disease. Should I be worried? What does this indicator mean and what is its normal value? In order not to panic, it is advisable to navigate this issue.

What is ESR in the blood

This is one of the indicators of blood tests - the erythrocyte sedimentation rate. More recently, there was another name - ROE. It was deciphered as an erythrocyte sedimentation reaction, but the meaning of the study has not changed. The result indirectly shows that there are inflammations or pathologies. Deviation of parameters from the norm requires additional examinations to establish a diagnosis. The index is affected by:

• elevated temperature;
• infections;
• chronic inflammation.

The body is healthy - and all blood components: platelets, leukocytes, erythrocytes and plasma are balanced. With the disease, changes are observed. Erythrocytes - red blood cells - begin to stick to each other. During analysis, they settle down with the formation of a plasma layer from above. The speed at which this process takes place is called ESR - normally, this indicator indicates a healthy body. Assign an analysis to:

• diagnostics;
• clinical examination;
• prevention;
• monitoring the outcome of treatment.

Well, when the ESR is normal. What do its high and low values ​​mean? An increase in the standard - accelerated erythrocyte sedimentation syndrome - indicates the likelihood of:

• purulent inflammation;
• liver diseases;
• metabolic disorders;
• autoimmune pathologies;
• viral, fungal infections;
• oncology;
• hepatitis A;
• bleeding;
• stroke
• tuberculosis;
• heart attack;
• recent injuries;
• high cholesterol;
• period after the operation.

Low values ​​are no less dangerous. The value is 2 units less than what the ESR should be according to the norm - this is a signal to look for a problem. The following reasons can reduce the erythrocyte sedimentation rate:

• poor outflow of bile;
• neuroses;
• hepatitis;
• epilepsy;
• vegetarianism;
• anemia;
• hormone therapy;
• circulatory problems;
• low hemoglobin;
• taking aspirin, calcium chloride;
• starvation.

Not always an increased value of the result of the analysis indicates inflammation or the presence of pathologies. There are situations when ESR is not the norm, but high or low rate but there is no threat to human health. This is typical for such circumstances:

• pregnancy;
• recent fractures;
• condition after childbirth;
• period;
• adherence to a strict diet;
• rich breakfast before tests;
• starvation;
• hormone therapy;
• puberty in a child;
• allergies.

To get reliable readings when decoding general analysis blood, you have to be ready. This requires:

• exclude alcohol for a day;
• come to the test on an empty stomach;
• stop smoking in an hour;
• stop taking medication;
• eliminate emotional, physical overload;
• do not play sports the day before;
• do not undergo an x-ray;
• stop physical therapy.

ESR according to Westergren

In order to establish whether the ESR norm in the body corresponds to the required parameters, there are two methods of verification. They differ in the method of sampling material, equipment for research. The essence of the process is the same, you need:

• take blood;
• add anticoagulant;
• stand an hour vertically on a special device;
• according to the height of the plasma in millimeters above the settled erythrocytes, evaluate the result.

The Westergren method involves taking blood from a vein. Sodium citrate is added in certain proportions to a test tube with a scale of 200 mm. Install vertically, hold for an hour. In this case, a layer of plasma is formed from above, erythrocytes settle down. There is a clear division between them. The erythrocyte sedimentation rate is the result of measuring in millimeters the difference between the upper border of the plasma and the top of the erythrocyte zone. Total indicator - mm / hour. Under modern conditions, special analyzers are used that determine the parameters in automatic mode.

ESR according to Panchenkov

The research method according to Panchenkov differs by sampling for the analysis of capillary blood. When comparing indicators with the Westergren method, the norm of clinical ESR coincides in the region usual values. With increasing readings, the Panchenkov method gives lower results. The parameters are defined as follows:

• take a capillary on which 100 divisions are applied;
• take a blood sample from a finger;
• dilute it with sodium citrate;
• make the setting of the capillary vertically for an hour;
• measure the height of the plasma layer above the erythrocytes.

ESR norm in women

With the peculiarities of physiology, the norm of ESR in the blood in women is associated. She is taller than men. Contribute to it hormonal changes during menstruation, pregnancy, puberty, menopause. The increase in indicators is influenced by the use of contraceptives, excess weight. What should be the ESR in women different ages? The following indicators are accepted - mm / hour:

• up to 15 years - 4-20;
• from 15 to 50 - 2-20;
• from 51 - 2-30.

ESR during pregnancy

For the period of expectation of the child, the ESR indicator is the norm, which is specifically agreed upon. It is increased compared to normal indicators and changes during the period, two weeks before delivery, its growth is possible. ESR in pregnant women also depends on the physique. The following indicators are observed - mm / hour:

• dense constitution - the first half - 8-45, the second part of the term - 30-70;
• thin figure - up to the middle - 21-63, in the next period of time - 20-55.

Aptinov M.M.- Head of the training center of West Medica

The erythrocyte sedimentation rate (ESR) is an indicator, the definition of which is included in the general blood test. This is a non-specific laboratory screening test, the change of which may serve as an indirect sign of the current inflammatory or other pathological processes, such as malignant tumors and diffuse connective tissue diseases.

The erythrocyte sedimentation rate is determined in blood diluted with citrate for a certain period of time (1 hour) and expressed in mm per 1 hour. The ESR value is determined as the distance from the lower part of the superficial meniscus (clear plasma) to the upper part of the settled erythrocytes in a vertical column stabilized with citrate whole blood.

The specific gravity of erythrocytes is higher than the specific gravity of plasma, therefore, in a test tube, in the presence of an anticoagulant (sodium citrate), under the action of gravity, erythrocytes settle to the bottom. The process of sedimentation (sedimentation) of erythrocytes can be divided into 3 phases that occur at different rates:

First phase: slow sedimentation of individual erythrocytes.

Second phase: the formation of erythrocyte aggregates (the so-called "coin columns"), the acceleration of sedimentation.

Third phase: the formation of many aggregates of erythrocytes and their "packing", sedimentation slows down and gradually stops.

The ESR indicator varies depending on many physiological and pathological factors. ESR values slightly higher in women than in men. Changes in the protein composition of the blood during pregnancy lead to increase in ESR in this period. A decrease in the content of erythrocytes in the blood (anemia) leads to an acceleration of ESR and, on the contrary, an increase in the content of erythrocytes in the blood slows down the rate of sedimentation. During the day, fluctuations in values ​​are possible, the maximum level is noted in the daytime.

The main factor influencing the formation of "coin columns" during erythrocyte sedimentation is the protein composition of blood plasma. Acute-phase proteins, being adsorbed on the surface of erythrocytes, reduce their charge and repulsion from each other, promote the formation of coin columns and accelerated erythrocyte sedimentation. An increase in the level of acute phase proteins, for example, C-reactive protein, haptoglobin, alpha-1-antitrypsin, etc., in acute inflammation leads to an increase in ESR.

In acute inflammatory and infectious processes, a change in ESR is noted 24 hours after an increase in temperature and an increase in the number of leukocytes. In chronic inflammation, an increase in ESR is due to an increase in the concentration of fibrinogen and immunoglobulins. The determination of ESR in dynamics, in combination with other tests, is used to monitor the effectiveness of the treatment of inflammatory and infectious diseases.

Methods definitions of ESR

Panchenkov's method

Panchenkov's capillary. Standard glass capillary for the determination of ESR: length - 172 mm; outer diameter - 5 mm; hole diameter - 1.0 mm; clear brown graduation from 0 to 10 cm, scale step - 1.0 mm; the upper division of the scale is marked with "0" and the letter "K" (blood), opposite division 50 there is the letter "P" (reagent).

Device PR-3 (ESR-meter, Panchenkov apparatus)– is a plastic stand with slots for 20 capillaries.

Measurement time: one hour.

Determining procedure:

Prepare a 5% sodium citrate solution and place on a watch glass.

Rinse the capillary with 5% sodium citrate solution.

Collect capillary blood into the washed capillary.

Transfer the blood from the capillary to the watch glass.

Repeat steps 3 and 4.

Mix the blood with sodium citrate on a watch glass and refill the capillary.

Place the capillary in a Panchenkov stand. Start the timer for each capillary separately.

Westergren method

Standard capillary dimensions: length: 300 mm± 1.5 mm; diameter: 2.55 mm± 0.15 mm

Standard temperature (18-25˚С) and conditions (no later than 2 hours after blood sampling).

Measurement time: one hour.

Determining procedure:

When taking a sample of venous blood, mix it with a 5% solution of sodium citrate in a ratio of 4 + 1.

Collect capillary blood into a Westergren capillary.

Install the capillary vertically. Start the timer for each capillary separately.

After 1 hour, determine the ESR by the height of the transparent plasma column.

Modified Westergren method: Ves-matic system (Diesse - Italy).

Sample volume: 1 ml venous blood

Plastic test tubes (vacuum and plain)

Operator safety (measurement performed in sealed tubes)

Automatic mixing

Measurement in 20 minutes (10 min fast mode)

Tube angle: 18°

Temperature correction of the results according to the Manly nomogram

Ease of use.

Objectivity of measurement (the result does not depend on the operator).

Built-in thermal printer.

Several models of devices with different performance 10, 20 or 30 tests in 20 minutes:

- Ves-matic Easy(10 positions, up to 30 tests per hour)

- Ves-matic 20(20 positions, up to 60 tests per hour)

- Ves-matic 30 plus

- Ves-matic 30(30 positions, up to 180 tests per hour)

- Ves-matic Cube 200(200 positions, up to 200 tests per hour)