What is the ESR indicator in the blood? All about the definition of ESR. ESR norm for adults and children: indicators with interpretation

Erythrocyte sedimentation rate is a test used to detect inflammation in the body.

The sample is placed in an elongated thin tube, red blood cells (erythrocytes) gradually settle to the bottom, and the ESR is a measure of this settling rate.

The test can diagnose many disorders (including cancer) and is a necessary test to confirm many diagnoses.

Let's figure out what it means when the erythrocyte sedimentation rate (ESR) in the general blood test of an adult or child is increased or decreased, should we be afraid of such indicators and why does this happen in men and women?

Women have higher ESR values, pregnancy and menstrual period may cause short-term deviations from the norm. In pediatrics, this test helps diagnose rheumatoid arthritis in children or.

Normal ranges may vary slightly depending on laboratory facilities. Abnormal results do not diagnose a specific disease.

Many factors such as age or use medicines , can affect the final result. Drugs such as dextran, ovidone, silest, theophylline, vitamin A can increase ESR, and aspirin, warfarin, cortisone can reduce it. High/low readings only tell the doctor about the need for further examination.

False promotion

A number of conditions can affect the properties of blood, affecting ESR value. Therefore, accurate information about the inflammatory process - the reason why the specialist prescribes a test - may be masked by the influence of these conditions.

In this case, the ESR values will be falsely elevated. These complicating factors include:

Anemia (low red blood cell count, decreased hemoglobin in serum);
Pregnancy (in the third trimester, ESR increases approximately 3 times);
Increased concentration of cholesterol (LDL, HDL, triglycerides);
Kidney problems (including acute kidney failure).

The specialist will take into account all possible internal factors when interpreting analysis results.

Interpretation of results and possible reasons

What does it mean if the erythrocyte sedimentation rate (ESR) in the blood test of an adult or child is increased or decreased, should we be afraid of indicators that are higher than normal or lower?

High levels in blood test

Inflammation in the body provokes red blood cells to stick together (the weight of the molecule increases), which significantly increases their rate of settling to the bottom of the test tube. Increased sedimentation levels may be caused by the following:

Autoimmune diseases – Libman-Sachs disease, giant cell disease, polymyalgia rheumatica, necrotizing vasculitis, rheumatoid arthritis (the immune system is the body’s defense against foreign substances. Against the background of an autoimmune process, it mistakenly attacks healthy cells and destroys body tissue);
Cancer (this can be any form of cancer, from lymphoma or multiple myeloma to bowel and liver cancer);
Chronic kidney disease (polycystic kidney disease and nephropathy);
Infection, such as pneumonia, pelvic inflammatory disease, or appendicitis;
Inflammation of the joints (polymyalgia rheumatica) and blood vessels (arteritis, diabetic angiopathy lower extremities, retinopathy, encephalopathy);
Inflammation thyroid gland(diffuse toxic goiter, nodular goiter);
infections of the joints, bones, skin, or heart valves;
Too high serum fibrinogen concentrations or hypofibrinogenemia;
Pregnancy and toxicosis;
Viral infections (HIV, tuberculosis, syphilis).

Because the ESR is a nonspecific marker of inflammation foci and correlates with other causes, the results of the analysis should be taken into account together with the patient’s health history and the results of other examinations (complete blood count - extended profile, urinalysis, lipid profile).

If the sedimentation rate and the results of other tests coincide, the specialist can confirm or, conversely, exclude the suspected diagnosis.

If the only one increased rate in the analysis is ESR (against the background of a complete absence of symptoms), the specialist cannot give an accurate answer and make a diagnosis. Besides, normal result does not exclude illness. Moderately elevated levels may be caused by aging.

Very large numbers usually have good reasons, such as multiple myeloma or giant cell arteritis. People with Waldenström's macroglobulinemia (the presence of abnormal globulins in the serum) have extremely high ESR levels, although there is no inflammation.

This video describes in more detail the norms and deviations of this indicator in the blood:

Low performance

Low sedimentation rates are generally not a problem. But may be associated with such deviations as:

A disease or condition that increases red blood cell production;
A disease or condition that increases white blood cell production;
If the patient is undergoing treatment inflammatory disease, the degree of sedimentation going down is a good sign and means that the patient is responding to treatment.

Low values can be caused by the following reasons:

Elevated glucose levels (in diabetics);
Polycythemia (characterized by increased number erythrocytes);
Sickle cell anemia ( genetic disease related to pathological changes cell shapes);
Severe liver diseases.

The reasons for the decline could be any number of factors., For example:

Pregnancy (in the 1st and 2nd trimester, ESR levels drop);
Anemia;
Menstrual period;
Medicines. Many medications can falsely lower test results, such as diuretics and medications that contain high calcium levels.

Increased data for diagnosing cardiovascular diseases

In patients with cardiac or myocardial disease, ESR is used as an additional potential indicator coronary disease hearts.

ESR used for diagnostics– (inner layer of the heart). Endocarditis develops due to the migration of bacteria or viruses from any part of the body through the blood to the heart.

If symptoms are ignored, endocarditis destroys the heart valves and leads to life-threatening complications.

To make a diagnosis of endocarditis, a specialist must prescribe a blood test. Along with high levels of sedimentation rates, endocarditis is characterized by a decrease in platelets(lack of healthy red blood cells), the patient is often also diagnosed with anemia.

Against the background of acute bacterial endocarditis, the degree of sedimentation may increase to extreme values(about 75 mm/hour) is acute inflammatory process, characterized by severe infection of the heart valves.

When diagnosing congestive heart failure ESR levels are taken into account. This is a chronic, progressive disease that affects the power of the heart muscles. Unlike regular “heart failure,” congestive heart failure refers to the stage in which excess fluid accumulates around the heart.

To diagnose the disease, in addition to physical tests (echocardiogram, MRI, stress tests), the results of a blood test are taken into account. In this case, analysis for an extended profile may indicate the presence of abnormal cells and infections(sedimentation rate will be higher than 65 mm/hour).

At myocardial infarction An increase in ESR is always provoked. Coronary arteries deliver oxygen in the blood to the heart muscle. If one of these arteries becomes blocked, part of the heart is deprived of oxygen, causing a condition called “myocardial ischemia.”

Against the background of a heart attack, ESR reaches peak values(70 mm/hour and above) for a week. Along with increased sedimentation rates, the lipid profile will show elevated levels of triglycerides, LDL, HDL and cholesterol in the serum.

A significant increase in erythrocyte sedimentation rate is observed against the background acute pericarditis. This, which begins suddenly, causes blood components such as fibrin, red blood cells and white blood cells to enter the pericardial space.

Often the causes of pericarditis are obvious, such as recent heart attack. Along with elevated ESR levels (above 70 mm/hour), an increase in urea concentration in the blood was noted as a result of renal failure.

Erythrocyte sedimentation rate increases significantly against the background of the presence of an aortic aneurysm or . Together with high ESR values (above 70 mm/hour), the arterial pressure, patients with an aneurysm are often diagnosed with a condition called “thick blood.”

conclusions

ESR plays an important role in the diagnosis of cardiovascular diseases. The indicator appears to be elevated against the background of many acute and chronic painful conditions, characterized by tissue necrosis and inflammation, and is also a sign of blood viscosity.

Elevated levels directly correlate with the risk of myocardial infarction and coronary heart disease. At high levels subsidence and suspicion of cardiovascular disease the patient is referred for further diagnostics, including an echocardiogram, MRI, electrocardiogram to confirm the diagnosis.

Experts use erythrocyte sedimentation rate to determine foci of inflammation in the body; measuring ESR is a convenient method of monitoring the progress of treatment of diseases accompanied by inflammation.

Accordingly, a high sedimentation rate will correlate with greater disease activity and indicate the presence of such possible states, How chronic illness kidneys, infections, inflammation of the thyroid gland and even cancer, while low values indicate a less active development of the disease and its regression.

Although sometimes even low levels correlate with the development of certain diseases, for example, polycythemia or anemia. In any case, consultation with a specialist is necessary for a correct diagnosis.

The measurement of erythrocyte sedimentation rate (ESR) and the use of this indicator as a method of medical diagnosis was proposed by the Swedish researcher Faro back in 1918. First, he was able to establish that the ESR rate in pregnant women is significantly higher than in non-pregnant women, and then he discovered that an increase in ESR indicates many diseases.

But in medical protocols Blood tests showed this indicator only decades later. First, Westergren in 1926, and then Winthrop in 1935, developed methods for measuring erythrocyte sedimentation rate, which are widely used in medicine today.

Laboratory characteristics of ESR

The erythrocyte sedimentation rate shows the ratio of plasma protein fractions. Due to the fact that the density of red blood cells is higher than the density of plasma, they slowly settle to the bottom under the influence of gravity in a test tube. Moreover, the very speed of this process is determined by the degree of aggregation of red blood cells: the higher the level of blood cell aggregation, the lower their frictional resistance and the higher the sedimentation rate. As a result, a thick burgundy sediment of red blood cells appears at the bottom of the test tube or capillary, and a translucent liquid remains in the upper part.

Interestingly, the erythrocyte sedimentation rate, in addition to the red blood cells themselves, is also influenced by others chemical substances included in the blood. In particular, globulins, albumins and fibrinogen are able to change the surface charge of red blood cells, increasing their tendency to “stick together”, thereby increasing ESR.

At the same time, ESR is a nonspecific laboratory indicator, which cannot be used to clearly judge the reasons for its change relative to the norm. At the same time, its high sensitivity is valued by doctors, who, when the erythrocyte sedimentation rate changes, have a clear signal for further examination of the patient.
The ESR is measured in millimeters per hour.

In addition to the methods of measuring the erythrocyte sedimentation rate of Westergren and Winthrop, in modern medicine The Panchenkov method is also used. Despite some differences in these methods, they show approximately the same results. Let's consider all three methods of studying ESR in more detail.

The Westergren method is the most common in the world and is approved by the International Committee for Standardization of Blood Research. This method involves collecting venous blood, which is combined for analysis in a 4 to 1 ratio with sodium citrate. The diluted blood is placed in a capillary 15 centimeters long with a measuring scale on its walls and after an hour the distance from upper limit settled red blood cells to the upper limit of the plasma. The results of ESR studies using the Westergren method are considered as objective as possible.

The Winthrop method of studying ESR differs in that blood is combined with an anticoagulant (it inhibits the blood's ability to clot) and placed in a tube with a scale on which ESR is measured. However, this technique is considered not indicative for high erythrocyte sedimentation rates (more than 60 mm/h), since in this case the tube becomes clogged with settled blood cells.

According to Panchenkov, the study of ESR is as similar as possible to Westergren’s methodology. Blood diluted with sodium citrate is placed to settle in a capillary, divided into 100 units. An hour later, the ESR is measured.

Moreover, the results according to the methods of Westergren and Panchenkov are the same only in the normal state, and with an increase in ESR, the first method records more high performance. In modern medicine, when the ESR increases, it is the Westergren method that is considered more accurate. IN Lately In modern laboratories, automatic instruments have also appeared for measuring ESR, the operation of which actually does not require human intervention. The function of a laboratory employee is only to decipher the results obtained.

Norms of erythrocyte sedimentation rate

The normal ESR indicator varies quite seriously depending on the gender and age of the person. The gradations of this standard for a healthy person are specifically designated and for clarity, we present them in the form of a table:

In some gradations of ESR norms for people aged 60 years and over, not a specific indicator is used, but a formula. In this case, for older men the upper limit of normal is equal to age divided by two, and for women it is age plus “10” divided by two. This technique is used quite rarely and only by certain laboratories. The values of the maximum ESR norm can reach 36-44 mm/h and even higher values, which is already considered by most doctors to be a signal of the presence of pathology and the need for medical research.

It is worth noting once again that the ESR norm in a pregnant woman may differ significantly from the indicators given in the table above. While expecting a child, the erythrocyte sedimentation rate can reach 40-50 mm/h, which in no way indicates a disease or pathology and is not a prerequisite for any further research.

Reasons for the increase in ESR

An increase in ESR may indicate tens various diseases and abnormalities in the body, so it is always used in conjunction with other laboratory tests. But at the same time, in medicine there is a certain list of groups of diseases in which the erythrocyte sedimentation rate invariably increases:

blood diseases (particularly sickle cell anemia irregular shape erythrocytes provokes an increase in the erythrocyte sedimentation rate, which differs significantly from the normative indicators);
heart attacks and (in this case, acute-phase inflammatory proteins are adsorbed on the surface of blood cells, reducing their electrical charge);
diseases associated with metabolic disorders (diabetes mellitus, cystic fibrosis, obesity);
diseases of the liver and biliary tract;
leukemia, lymphoma, myeloma (with myeloma, the erythrocyte sedimentation rate in almost all cases exceeds 90 mm/h and can reach 150 mm/h);
malignant neoplasms.

In addition, an increase in ESR is observed with most inflammatory processes in the body, with anemia and with various infections.
Modern statistics of laboratory studies have collected enough data on the reasons for the increase in ESR, which made it possible to create a kind of “rating”. The absolute leader causing an increase in ESR are infectious diseases. They account for 40 percent of detections of ESR exceeding the norm. The second and third places on this list with results of 23 and 17 percent were taken by oncological diseases and rheumatism. In eight percent of cases where a high erythrocyte sedimentation rate was recorded, this was caused by anemia, inflammatory processes in the gastrointestinal tract and pelvic area, diabetes mellitus, injuries and diseases of the ENT organs, and in three percent of cases, an increased ESR was a signal of kidney disease.

Despite the fact that the collected statistics are quite eloquent, you should not independently diagnose yourself using the ESR indicator. Only a doctor can do this, using several laboratory tests in combination. The ESR indicator can increase very seriously, up to 90-100 mm/h, regardless of the type of disease, but in terms of the result of the study, the erythrocyte sedimentation rate cannot serve as a marker of a specific cause.

There are also prerequisites under which an increase in ESR does not reflect the development of any disease. In particular, sharp increase indicator is observed in pregnant women, and a slight increase in ESR is possible with allergic reactions and even on the type of food: diet or fasting lead to changes in blood tests and, to one degree or another, affect the ESR. In medicine, this group of factors is called the causes of a false-positive ESR analysis, and they try to exclude them even before the examination.
In a separate paragraph, it is worth mentioning cases where even in-depth studies do not show the reasons for the increase in ESR. Very rarely, a constant overestimation of this indicator may be a feature of the body that has neither prerequisites nor consequences. This feature is typical for every twentieth inhabitant of the planet. But even in this case, it is recommended to be regularly examined by a doctor so as not to miss the development of any pathology.

It is also important that in most diseases, the increase in ESR does not begin immediately, but after a day, and after recovery, the restoration of this indicator to normal can last up to four weeks. Every doctor should remember this fact so that after completing the course of treatment, he does not subject the person to additional studies due to a residual increase in ESR.

Reasons for an increase in ESR in a child

The body of children traditionally differs from that of an adult in terms of laboratory test results. The erythrocyte sedimentation rate is no exception, the growth of which in a child is provoked by a slightly modified list of prerequisites.

In most cases, an increased ESR in the blood of a child indicates the presence of an infectious-inflammatory process in the body. This is often confirmed by other results in a general blood test, which, together with ESR, almost immediately form a picture of the child’s condition. Moreover, in a small patient, an increase in this indicator is often accompanied by a visual deterioration of the condition: weakness, apathy, lack of appetite - a classic picture of an infectious disease with the presence of an inflammatory process.

From non-communicable diseases, which most often provoke an increased ESR in a child, the following should be highlighted:

pulmonary and extrapulmonary forms of tuberculosis;
anemia and blood diseases;
diseases associated with metabolic disorders;
injuries.

However, if an increased ESR is detected in a child, the reasons may be quite harmless. In particular, going beyond the normal range of this indicator can be triggered by taking paracetamol - one of the most popular antipyretics, teething in infants, the presence of worms (helminth infections), and a deficiency of vitamins in the body. All these factors are also false positives and should be taken into account at the stage of preparation for a laboratory blood test.

Reasons for low ESR

A low relative to normal erythrocyte sedimentation rate is quite rare. In most cases, this situation is provoked by disorders of hyperhydration (water-salt metabolism) in the body. In addition, low ESR may be a consequence of developing muscle dystrophy and liver failure. Among Not pathological reasons low rate ESR is distinguished by taking corticosteroids, smoking, vegetarianism, prolonged fasting and pregnancy. early stages, but there is practically no consistency in these prerequisites.
Finally, let’s summarize all the information about ESR:

this is a non-specific indicator. It is impossible to diagnose the disease using it alone;
An increase in ESR is not a reason for panic, but it is a reason for in-depth analysis. The reasons can be both very harmless and quite serious;
ESR is one of the few laboratory tests that is based on a mechanical action rather than a chemical reaction;
Automatic systems for measuring ESR that were not available until recently made laboratory technician error the most common cause of a false erythrocyte sedimentation rate test result.

In modern medicine, erythrocyte sedimentation rate continues to be perhaps the most popular laboratory research blood. High sensitivity analysis allows doctors to clearly determine whether the patient has problems and prescribe further examination. The only serious drawback of this study is the strong dependence of the result on the correct actions of the laboratory assistant, but with the advent of automatic systems for determining ESR, the human factor can be eliminated.

Erythrocyte sedimentation rate is an important laboratory blood parameter, the results of which can be used to determine the ratio of plasma protein fractions. If the ESR deviates from the norm, this indicates the presence of a certain pathological process in the body.

Who is the test prescribed for?

ESR is one of the most important ways diagnosis of many diseases. As a rule, using this analysis it is possible to detect the following pathologies:

Inflammatory diseases.
Infections.
Neoplasms.
Screening diagnostics during preventive examinations.

Determining ESR is a screening test that is not specific for a particular disease. Erythrocyte sedimentation rate is a test that is actively used in general blood tests.

Preparatory activities

Determination of ESR is an analysis that must be carried out on an empty stomach. It is necessary not to consume fatty, fried foods and alcoholic beverages 3 days before the erythrocyte sedimentation test. An hour before blood is taken to determine the erythrocyte sedimentation rate, you need to refrain from smoking.

Decoding

The interpretation of ESR in the analysis is very nonspecific. The type of disease in women and men can be more accurately determined by taking the ESR level and the number of leukocytes together. The determination of these indicators in women and men is carried out after the doctor studies them over time by days of illness.

For example, if there is an acute myocardial infarction, then the leukocyte rate is increased already in the first hours of the disease, but the ESR in women and men is normal. On days 5–10, the “scissors” symptom occurs, in which the leukocyte rate drops, but the erythrocyte sedimentation rate rate in women and men is increased. After this, the leukocyte norm is maintained, but the erythrocyte sedimentation rate in men and women is used to judge the formation of scars on the heart muscle and the effectiveness of the therapy.

Combination high content leukocytes and increased speed Erythrocyte sedimentation makes it possible to continue the diagnosis and find the source of inflammation.

The rate of erythrocyte sedimentation rate in women and men is increased when allergic processes are diagnosed, especially for diseases such as lupus erythematosus and rheumatoid polyarthritis.

Interpretation of elevated erythrocyte sedimentation rate figures makes it possible to identify tumor diseases, acute leukemia, multiple myeloma. Also, the erythrocyte sedimentation rate is important in diagnosing anemia, determining the degree of blood loss in injuries, surgical treatment, kidney diseases.

The erythrocyte sedimentation rate can also be increased in case of infectious diseases:

rheumatism;
tuberculosis;
viral infection.

Low erythrocyte sedimentation rates indicate changes in blood components and the structure of the red blood cells themselves. In this case, the following diseases are diagnosed:

polycythemia;
sickle cell anemia;
spherocytosis;
hyperbilirubinemia;
overhydration.

Very often, low ESR becomes a variant of the norm in vegetarians who do not eat meat and different foods animal origin.

Reasons for increased ESR:

pregnancy, postpartum period, menstruation;
inflammatory diseases;
paraproteinemia;
tumor diseases (carcinoma, sarcoma, acute leukemia);
connective tissue diseases;
glomerulonephritis, renal amyloidosis, occurring with nephrotic syndrome, uremia;
severe infections;
hypoproteinemia;
anemia;
hyper- and hypothyroidism;
internal bleeding;
hyperfibrinogenemia;
hemorrhagic vasculitis;
rheumatoid arthritis.

Reasons for low ESR:

erythremia and reactive erythrocytosis;
pronounced symptoms of circulatory failure;
epilepsy;
hemoglobinopathy C;
hyperproteinemia;
hypofibrinogenemia;
viral hepatitis and obstructive jaundice;
taking calcium chloride, salicylates.

Under normal conditions, the process of erythrocyte sedimentation in men and women occurs slowly, the rate after an hour will be below normal. When diagnosing various diseases, the composition of the blood will suggest increased content fibrin, proteins. Under their influence, rapid sedimentation of erythrocytes occurs, and the ESR value increases.

Normal level

ESR norm in the blood depends on parameters such as the physiological state and age of the patient. They are different for men and women. There is information that this indicator differs among residents of different territories.

Table 2 - Normal ESR values

New methods for diagnosing and determining the causes of diseases appear in modern medicine regularly. However, the definition ESR indicator in human blood is still an effective diagnostic method. It is used for diagnostic purposes in both children and adults. Such a study is prescribed both when a patient who is concerned about a certain disease contacts a doctor, and during preventive examinations.

Any doctor can interpret this test. ESR is included in the group general blood tests (UAC). If this indicator is elevated, you need to determine the cause of this phenomenon.

What is ESR in the blood?

Those who are prescribed such a study are interested in why an ESR analysis is performed and what it is. So, the abbreviation ESR is the capital letters of the term “ erythrocyte sedimentation rate " Thus, with this test the settling rate can be determined accurately in blood.

Red blood cells – these are, as you know, red blood cells. When acting on them anticoagulants over a certain period they settle at the bottom of the capillary or test tube. The time during which a blood sample taken from a patient is divided into upper and lower layers is defined as ESR. It is rated by height layer plasma , which was obtained during the research process, in millimeters per 1 hour. The ESR indicator is nonspecific, however, it has high sensitivity.

If the ESR level in the blood is elevated, this may indicate the development of various disorders in the body. So, sometimes this is an indicator of the development of infectious, oncological, rheumatological and other pathologies even before the manifestation of obvious symptoms of diseases. Accordingly, if ESR level normal, the doctor prescribes other tests if necessary.

The ESR norm for women is 3 to 15 mm/h. But you need to take into account that this indicator also depends on age - normally it can be different for women under 30 and after 30 years. If necessary, the norm of red blood cells in the blood of women is also determined. In pregnant women, ESR increases starting from the fourth month. It should be taken into account that the ESR rate in pregnant women may vary depending on the period of gestation.

The norm for ESR in men is from 2 to 10 mm/h. A general blood test also determines red blood cells in the blood of men.

The normal ESR level in the blood of children depends on the age of the patient.

This value in the diagnostic process is important for:

differentiation of diagnosis ( And , and , and osteoarthritis and etc.);
determining the body's response during the treatment of patients, lymphogranulomatosis , rheumatoid arthritis and etc.;
definition of a disease that occurs latently (but it should be borne in mind that even normal values ESR does not exclude the development of a disease or neoplasm in the body).

Sometimes this concept is referred to as ROE . ROE in the blood and ESR are identical concepts. Speaking about ROE in the blood, we understand that it is erythrocyte sedimentation reaction . Once upon a time in medicine this very concept was used, that is, they were defined ROE norm in the blood for women, the norm of ROE in the blood for children, etc. Currently, this concept is considered outdated, but any doctor understands what ROE is in a blood test, what ROE is in oncology, etc.

Diseases in which there is an increased ESR in the blood

If a patient has an elevated ESR in the blood, what this means is determined by the doctor during the diagnostic process. After all, this indicator is very important for diagnosis if the development of a certain disease is suspected. In the diagnostic process, a qualified doctor takes into account not only the fact that the patient has an increased value, but also determines what the presence of other symptoms indicates. But still this indicator is very important in many cases.

Increased ESR in the blood of a child and an adult is observed if it occurs bacterial infection - during the acute phase of a bacterial infection.

In this case, it does not matter where exactly the infections are localized: the picture of the peripheral blood will still reflect the inflammatory reaction.

This value is always increased in an adult, if there are viral infectious diseases . What specifically causes this indicator to increase is determined by the doctor during a comprehensive examination.

Thus, we are talking about the development of a certain pathological process if the ESR is higher than normal. What this means depends on the value of the indicator. Very high values – more than 100 mm/h – occur with the development of infectious diseases:

at , pneumonia , cold , and etc.;
at , and others urinary tract infections ;
at fungal infection X, viral hepatitis ;
at oncology (high rates can be observed for a long time).

During the development of an infectious disease, this value does not increase quickly; an increase is observed after 1-2 days. If the patient has recovered, the ESR will be slightly elevated for several more weeks or months. The reasons for a high ESR with normal leukocytes may indicate that the person has recently had viral disease: that is, the leukocyte count has already returned to normal, but the red cell sedimentation rate has not yet.

The reasons for increased ESR in the blood in women may be associated with pregnancy, therefore, in the diagnostic process, the doctor must take into account these reasons for the increase in ESR in the blood in women.

An increase in ESR is typical sign for the following diseases:

diseases of the biliary tract and liver;
inflammatory diseases of a purulent and septic nature ( reactive arthritis and etc.);
blood diseases ( sickle anemia , hemoglobinopathies , anisocytosis );
illnesses that cause tissue destruction And ( , heart attack , tuberculosis , neoplasms of a malignant nature);
endocrine gland pathologies and disorders metabolic processes ( , diabetes , cystic fibrosis and etc.);
malignant degeneration bone marrow, in which red blood cells enter the blood that are not ready to perform direct functions ( multiple myeloma , );
autoimmune diseases (, lupus erythematosus , and etc.);
acute conditions in which the blood becomes more viscous (, bleeding , vomit , postoperative conditions and etc.).

Normal and pathological ESR values

In medicine, the physiological limits of this indicator are determined, which are the norm for certain groups of people. Normal and maximum values are shown in the table:

ESR during pregnancy

If given value elevated at , this is considered a normal condition. The normal ESR rate during pregnancy is up to 45 mm/h. With such values expectant mother there is no need to further examine and suspect the development of pathology.

Methods used to test ESR blood

Before deciphering what ESR means in a blood test, the doctor uses a certain method to determine this indicator. It should be noted that the results of different methods differ and are not comparable.

Things to consider before performing an analysis blood ESR that the resulting value depends on several factors. The general analysis must be carried out by a specialist - a laboratory employee, and only high-quality reagents are used. The analysis in children, women and men is carried out provided that the patient has not eaten food for at least 4 hours before the procedure.

What does the ESR value show in the analysis? First of all, the presence and intensity of inflammation in the body. Therefore, if there are deviations, patients are often prescribed biochemical analysis. Indeed, for high-quality diagnostics it is often necessary to find out in what quantity a certain protein is present in the body.

Westergren ESR: what is it?

The described method for determining ESR is Westergren method — today meets the requirements of the International Committee for Standardization of Blood Research. This technique is widely used in modern diagnostics. For such an analysis you need deoxygenated blood, which is mixed with sodium citrate . To measure ESR, the distance of the stand is measured, the measurement is taken from the upper limit of the plasma to the upper limit of the red blood cells that have settled. The measurement is carried out 1 hour after the components have been mixed.

It should be noted that if Westergren's ESR is elevated, this means that for diagnosis this result more indicative, especially if the reaction is accelerated.

ESR according to Wintrob

The essence Wintrobe method - examination of undiluted blood that was mixed with an anticoagulant. The desired indicator can be interpreted using the scale of the tube in which the blood is located. However, this method has a significant drawback: if the reading is above 60 mm/h, the results may be unreliable due to the fact that the tube is clogged with settled red blood cells.

ESR according to Panchenkov

This method involves the study of capillary blood, which is diluted with sodium citrate - 4:1. Next, the blood is placed in a special capillary with 100 divisions for 1 hour. It should be noted that when using the Westergren and Panchenkov methods, the same results are obtained, but if the speed is increased, then the Westergren method shows higher values. Comparison of indicators is in the table below.

According to Panchenkov (mm/h)	Westergren (mm/h)
15	14
16	15
20	18
22	20
30	26
36	30
40	33
49	40

Currently, special automatic counters are also actively used to determine this indicator. To do this, the laboratory assistant no longer needs to dilute the blood manually and track the numbers.

ESR in the blood: what do certain values mean?

As mentioned above, normal ESR values for a healthy man are considered to be 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 mm per hour; for women, the normal value is from 2 to 15 mm/hour. Therefore, for women, a value of 12, 13, 14, 15 is considered normal. However, indicators for women in adulthood can normally be 16, 17, 18, 19, 20.

If the value exceeds the norm by several units, then the blood condition can be considered relatively normal. That is, an indicator of 21, 22 in a woman can be considered acceptable, as well as values of 23, 24 mm/h. When a woman is carrying a child, this significance is even greater. Therefore, expectant mothers have no reason to believe that a reading of 25 means something unpleasant. During pregnancy, analysis may show 28, 29. ESR 30, 31, 32, 33, 34, 35, 36, 38 is also not evidence of the development of pathological processes in pregnant women.

This indicator increases with age. Therefore, if an ESR value of 40 is noted in elderly patients, the doctor determines what disease this is a symptom of and what it means by the accompanying signs. Normal values for older people are 43, 50, 52, 55 mm/h, etc. However, for young people, values of 40-60 mm/h are possibly evidence of serious disorders. Therefore, after receiving the analysis data, it is necessary to consult in detail about why the ESR is 60, what it could be, and undergo further research.

Low value

As a rule, the reasons for a low value of this indicator are associated with exhaustion of the body, weight loss, taking corticosteroids, hyperhydration, and muscle atrophy. Sometimes ESR is lowered in diseases of the heart and blood vessels.

What affects the ESR indicator?

In both women and men, the level of ESR is influenced by a number of different factors, both physiological and pathological. The key factors that most influence this analysis are identified:

When determining different methods- according to Westergren et al. - the norm of ESR in the blood of women is higher than that of men. So, an ESR of 25 in a woman may be normal. It's connected with physiological characteristics blood in women.
What is the normal ESR level in a woman’s blood depends on whether she is pregnant. For expectant mothers, the norm is from 20 to 45 mm/h.
A higher ESR is observed in women who take contraceptives . Under this condition, a woman may have a normal ESR of 30. What does this mean, is there a pathology, or are we talking about normal physiological indicator, must be determined by a doctor.
In the morning, the rate at which red cells settle is higher than in the afternoon and evening, and differences in age do not matter here.
Signs of accelerated sedimentation are observed when exposed to acute phase proteins.
If inflammation develops and infectious process, the values change a day after that. how they begin leukocytosis And hyperthermia . That is, on the first day of the disease the indicator can be 10, 14, 15 mm/h, and a day later it can increase to 17, 18, 20, 27, etc.
ESR is elevated if there is a chronic source of inflammation in the body.
A reduced value is observed when increased blood viscosity .
A decrease in sedimentation rate occurs under the influence of anisocytes and spherocytes; the rate becomes greater under the influence of macrocytes.

Elevated ESR in children

When the ESR norm in children is exceeded, most likely an infectious inflammatory process develops in the body. But it should be taken into account when determining ESR according to Panchenkov that other indicators of the UAC are also increased (or changed) in children ( and etc.). Also, in children with infectious diseases, the general state. For infectious ESR diseases high in the child already on the second or third day. The indicator can be 15, 25, 30 mm/h.

If red blood cells are elevated in a child’s blood, the reasons for this condition may be the following:

metabolic disorder ( diabetes , );
systemic or autoimmune diseases (, rheumatoid arthritis , lupus );
blood diseases , hemoblastoses , anemia ;
diseases in which tissue breakdown occurs ( tuberculosis , myocardial infarction , oncological diseases ).

It is necessary to take into account: if even after recovery the erythrocyte sedimentation rate is increased, this means that the process is proceeding normally. It’s just that normalization is slow, but after about one month after the disease, normal levels should be restored. But if there are doubts about recovery, then you need to do a re-examination.

Parents must understand that if a child's red blood cells are higher than normal, this means that pathological process takes place in the body.

But sometimes, if a baby’s red blood cells are slightly elevated, this means that some relatively “harmless” factors are influencing:

in infants, a slight increase in ESR may be associated with a violation of the mother's diet when;
period of teething;
after taking medications ();
at lack of vitamins ;
at helminthiasis .

Thus, if red blood cells are elevated in the blood, this means that the child is developing a certain disease. There are also statistics on the frequency of increase in this value in various diseases:

in 40% of cases, a high value indicates infectious diseases ( illnesses respiratory tract , tuberculosis , urinary tract diseases , viral hepatitis , fungal diseases );
in 23% - oncological processes different organs;
in 17% - rheumatism , systemic lupus ;
at 8% - , inflammation of the gastrointestinal tract , pelvic organs , anemia, ENT diseases , injuries , diabetes , pregnancy ;
3% — kidney disease .

When can increasing ESR be considered safe?

As is known, an increase in red blood cells in the blood, as a rule, indicates that a certain inflammatory reaction. But sometimes the reasons for the increase in red blood cells in the blood of women and men are not so categorical.

We are talking, first of all, about when analysis in men and women helps to judge whether anti-allergy treatment is being carried out correctly (fluctuations in the initially elevated ESR should be taken into account). That is, if clinical effect from the medicine occurs, then gradually the ESR norm in the blood of men, as well as in women, will be restored.

A hearty breakfast before the test can also increase this indicator; a strict diet and fasting can also change it.

ROE can change during menstruation, during pregnancy and after the birth of a child.

False-positive ESR tests

In medicine there is also a concept false positive analysis. An analysis of ESR is considered such if there are factors on which this value depends:

anemia (there is no morphological change in red blood cells);
increase in plasma protein concentration , with the exception of fibrinogen ;
hypercholesterolemia ;
renal failure ;
obesity high degree;
pregnancy ;
old age of a person;
introduction dextran ;
a technically incorrect study;
reception ;
recent vaccination against hepatitis B .

What to do if the reasons for the increase are not determined?

If the analysis is normal, but the reasons for the increased erythrocyte sedimentation rate cannot be determined, it is important to detailed diagnostics. Should be excluded oncological diseases Therefore, GRA, the norm of leukocytes in women and men are determined. During the analysis process, other indicators are also taken into account - whether the average volume of erythrocytes is increased (what this means - the doctor will explain) or whether the average volume of erythrocytes is decreased (what this means is also determined by the specialist). Urine tests and many other studies are also carried out.

But there are cases when high ESR levels are a feature of the body, and they cannot be reduced. In this case, experts advise regular medical examinations, and if a certain symptom or syndrome appears, consult a doctor.

How to reduce ESR in the blood?

The doctor will tell you in detail about ways to reduce this indicator with the help of medications after the study. He will prescribe a treatment regimen once a diagnosis has been made. It is strictly not recommended to take medications on your own. You can try to lower it folk remedies, which are mainly aimed at restoring normal function immune system , as well as for blood purification. Effective folk remedies can be considered herbal decoctions, teas with raspberries and lemon, beet juice, etc. How many times a day to take these remedies, how much you need to drink, you should find out from a specialist.