Analysis for soy what is the norm. What does it mean if the ESR is above the norm, what are the reasons for the increase and how to reduce the rate for adults and children? An increase in the level of ESR in a child

The abbreviation "ESR" stands for "erythrocyte sedimentation rate". This is a non-specific laboratory indicator, which is determined by the patient.

ESR refers to the methods of initial diagnosis. Correct interpretation allows you to determine the algorithm for further actions of the doctor.

History and essence of the method

In 1918, it was found that ESR changes in women during pregnancy. Later it turned out that a change in the indicator is observed in inflammatory diseases. One of the methods for determining the indicator, which is still widely used in clinical practice, was developed by Westergren back in 1928.

The density of red blood cells is higher than the density of plasma, and if the blood does not coagulate, the red blood cells, under their own weight, gradually sink to the bottom of the laboratory tube.

Notice:to prevent blood clotting, an anticoagulant substance - sodium citrate (5% or 3.8% solution) is added to the container before the study.

The leading factor affecting the sedimentation rate is the aggregation of erythrocytes (i.e., their adhesion to each other). The formed indivisible particles known as "coin columns" have a smaller area-to-volume ratio, so they overcome fluid (plasma) resistance more easily and settle faster. The larger the size and number of aggregates, the higher the ESR.

Aggregation is affected by the protein composition of the plasma and the surface potential of red blood cells. With the development of pathology of infectious and inflammatory genesis, the electrochemical composition of the blood changes. The main reason for the increase in aggregation is the presence in the blood of the so-called. "acute phase proteins" - immunoglobulins, fibrinogen, ceruloplasmin and C-reactive protein. Agglutination is normally prevented by the negative charge of red blood cells, but it tends to change when antibodies and acute phase fibrinogen are added.

Note:an altered electrical charge and an increased tendency to aggregation are characteristic of atypical forms of erythrocytes.

Slight reductions in albumin content have practically no effect on the sedimentation rate, but a significant decrease in concentration causes a decrease in serum viscosity and an increase in the index.

Research by the Panchenkov method

To assess the ESR using this method, a special laboratory vessel is used - the so-called. Panchenkov capillary. First, sodium citrate is added to it up to the “P” mark, and the anticoagulant is transferred to the glass. Then, the test blood is drawn twice in succession up to the “K” mark, and combined with citrate. Citrated blood is again drawn into the capillary, which is fixed in a vertical position. ESR is determined after 60 minutes. or after 24 hours; the indicator is expressed in millimeters. This method, which is most often used by doctors in our country, gives high accuracy in single studies. Its main disadvantage is that the analysis takes a relatively long time.

Research according to the method of Westergren

The European method is somewhat more sensitive to an increase in ESR. For analysis, Westergren tubes with a diameter of 2.5 mm and a graduation of 200 mm are used. The material for research is venous blood mixed with sodium citrate (3.8%) in a ratio of 4:1. A reagent such as ethylenediaminetetraacetic acid (EDTA) may be added to the blood. The indicator is expressed in mm/hour.

Important:studies according to Panchenkov and Westergren can give different numbers, and the higher the ESR, the greater the possible difference. Therefore, in the decoding of the analysis, it must be indicated by what method the analysis was done. If you received the results in a laboratory that determines the ESR according to international standards, be sure to check whether the results were brought to the standards of Panchenkov's indicators.

Interpretation of the results: normal ESR in adults and children

Normal ESR values differ depending on gender, age, and some individual characteristics of the subject.

Limits of the norm for adults:

for men - 2-12 mm / hour;
for women - 3-20 mm / hour.

Important:with age, the indicator increases, significantly going beyond the normal range. In older people, a speed of 40-50 mm / h can be determined, and this is not always a sign of infection, inflammation or other pathology. For women over 60 years of age, numbers in the range of 2-30 mm / hour are considered the norm, and for men of the same age - 2-20 mm / hour.

Limits of the norm for children of different ages (in mm / h):

newborns - up to 2;
from 2 to 12 months - 2-7;
from 2 to 5 years - 5-11;
from 5 to 12 years old - 4-17;
boys over 12 years old 2-15;
girls over 12 years old - 2-12.

The most common deviations are in the direction of increasing numbers. The inaccuracy of the analysis may be due to a violation of the rules for conducting. Blood for ESR must be taken on an empty stomach in the morning. If the subject was hungry the day before or, conversely, had dinner too tight, the results are distorted. In such situations, it is recommended to retake the analysis after 1-2 days. The result of ESR is influenced by the conditions of storage of biological material before the study.

What does an increase in ESR mean?

ESR analysis is famous for its simplicity and low cost, but the interpretation of the results often presents certain difficulties. Figures within the normal range do not always indicate the absence of an active pathological process.

It has been established that in a number of patients with diagnosed malignant diseases, this indicator is less than 20 mm/hour. As for cancer patients, a significant increase in the rate of red cell sedimentation is more typical for individuals with solitary tumors than for patients with malignant blood diseases.

In some cases, no disease is detected in subjects with an ESR of 100 mm/h and above.

The main reasons for the increase in ESR:

acute and chronic bacterial infections (infectious diseases of the respiratory and urinary systems, as well as);
viral infections (including);
fungal infections (systemic candidiasis);
malignant diseases (tumor neoplasms, lymphomas and multiple myeloma);
rheumatological diseases;
kidney disease.

An increase in ESR is also characteristic of some other diseases and conditions, including:

anemia;
chronic granulomatous periodontitis;
inflammation of the pelvic organs (for example, the prostate gland or appendages);
enterocolitis;
phlebitis;
significant injuries (including bruises and);
high tension;
condition after the operation.

Important:an increase in the erythrocyte sedimentation rate over 100 mm / h is most often detected with an active infectious process (including), malignant tumors, oncohematological diseases, systemic lesions of the connective tissue and kidney diseases.

An increased ESR does not necessarily indicate the presence of pathology. Within 20-30 mm / hour, it increases in pregnant women, during menstruation, as well as against the background of taking certain pharmacological drugs - in particular salicylates (Acetylsalicylic acid,), complexes containing

The erythrocyte sedimentation rate (ESR) is an indicator that determines the speed and intensity of erythrocyte agglutination in certain pathological processes. This analysis is one of the mandatory values of the general blood test, previously the analysis was called ROE and determined the reaction of erythrocyte sedimentation.

Changes and deviations from the norm indicate inflammation and the development of the disease. That is why, in order to stabilize the ESR, the disease is initially treated, and not artificially attempted to achieve the norm with the help of drugs.

As a rule, excess of the norm indicates a violation of the electrochemical structure of the blood, as a result of which pathological proteins (fibrinogens) attach to red blood cells. The appearance of such elements occurs against the background of bacterial, viral, infectious and fungal lesions, inflammatory processes.

Indications

Important! ESR is a non-specific indicator. This means that in isolation from other data, on the basis of ESR alone, it is impossible to make a diagnosis. Deviations in the erythrocyte sedimentation rate indicate only the presence of pathological changes.

An ESR analysis is a necessary step in diagnosing the structure of the blood, which at the earliest stages of the disease makes it possible to determine the presence of inflammatory processes in the body.

That is why ESR is prescribed for suspected pathologies of various nature:

inflammatory diseases;
infectious;
benign and malignant formations.

Additionally, screening is carried out at annual medical examinations.

ESR is used in the complex of clinical (general) analysis. After it, it is necessary to additionally use other diagnostic methods.

Even minor deviations from the norm must be considered conditionally pathological, requiring additional examination.

If a pathology of the hematopoietic system is suspected, the analysis of ESR becomes the main diagnostic value.

ESR norms

The erythrocyte sedimentation rate is measured in mm per hour.

ESR according to Westergren, ESR micromethod - venous blood is examined

ESR according to Panchenkov - capillary blood is examined (from a finger)

Depending on the type, form of the course (acute, chronic, recurrent) and the stage of development of the disease, ESR can change dramatically. To obtain a complete picture, a second study is carried out after 5 days.

ESR above normal

Important! A physiological increase in ESR can be observed in women during menstruation, during pregnancy and in the postpartum period.

As a rule, the erythrocyte sedimentation rate exceeds the norm in the following diseases:

inflammatory processes of various etiologies. The indicator increases as a result of increased production of globulins and fibrinogens during the acute phase of inflammation;
decay, tissue death, necrotic processes in cells. As a result of the breakdown, protein products enter the bloodstream, causing sepsis and purulent processes. This group includes oncological pathologies, tuberculosis, heart attacks (of the brain, myocardium, lungs, intestines), etc.;
metabolic disorders - hypo- and hyperthyroidism, diabetes at all stages, etc.;
nephrotic syndrome and hypoalbuminemia, liver pathology, severe blood loss, exhaustion;
anemia (anemia), hemolysis, blood loss and other pathologies of the circulatory system. As a result of the disease, the number of red blood cells in the body is reduced .;
vasculitis, connective tissue diseases: arthritis, periarteritis, scleroderma, rheumatism, lupus and many others;
hemoblastosis of all types (leukemia, Waldenström's disease, lymphogranulomatosis and others);
periodic hormonal changes in the female body (menstruation, childbearing and childbirth, the onset of menopause).

ESR below normal

Registered in the following cases:

disorders of the circulatory system associated with the production of red blood cells (erythremia, erythrocytosis, etc.), changes in their shape (hemoglobinopathy, spherocytosis, sickle cell anemia, and others);
prolonged fasting, dehydration;
congenital or hereditary circulatory failure;
violation of the nervous system: epilepsy, stress, neuroses, as well as mental disorders;
regular intake of certain medications: calcium chloride, salicylates, preparations containing mercury.

Upon receipt of the results of ESR, you need to contact a therapist who will decipher them and refer them to a highly specialized doctor (infectious disease specialist, hematologist, oncologist, immunologist, and others).

Self-medication and an attempt to artificially stabilize the ESR level will not give results, but will blur the picture for further research and competent therapy.

How to prepare for the procedure

A general blood test (within which ESR is detected) is carried out in the morning on an empty stomach. That is, between the last snack and the blood sampling procedure, about 8-10 hours should pass.

1-2 days before blood donation, it is necessary to give up alcohol, “heavy” food (fried, fatty, smoked), hot spices.

A couple of hours before the procedure, you should refrain from smoking (cigarettes, hookah, pipes, electronic cigarettes, etc.).

Severe stress, psychological stress, physical activity (running, climbing stairs, carrying weights) can also affect the level of red blood cells. Immediately before the manipulations, you need to rest for 30-60 minutes.

You should also tell your doctor about any medications you take regularly or on demand. Their active substances can affect the result of the analysis.

Keep in mind that each laboratory uses different methods of testing ESR and units of measurement. Therefore, it is necessary to do an analysis, undergo further (repeated) examination and treatment in the same hospital.

The erythrocyte sedimentation rate (ESR) is an indicator that is still important for diagnosing the body today. The definition of ESR is actively used to diagnose adults and children. Such an analysis is recommended to be taken once a year, and in old age - once every six months.

An increase or decrease in the number of bodies in the blood (erythrocytes, leukocytes, platelets, etc.) is an indicator of certain diseases or inflammatory processes. Especially often, diseases are determined if the level of the measured components is elevated.

In this article, we will look at why ESR is increased in a blood test, and what this means in each case in women or men.

ESR - what is it?

ESR is the sedimentation rate of erythrocytes, red blood cells, which, under the influence of anticoagulants, settle at the bottom of a medical test tube or capillary for some time.

The settling time is estimated from the height of the plasma layer obtained as a result of the analysis, estimated in millimeters per 1 hour. ESR is highly sensitive, although it refers to non-specific indicators.

What does it mean? A change in the erythrocyte sedimentation rate may indicate the development of a certain pathology of a different nature, moreover, even before the onset of the manifestation of obvious symptoms of the disease.

With this analysis can be diagnosed:

The response of the body to the prescribed treatment. For example, with tuberculosis, lupus erythematosus, inflammation of the connective tissue (rheumatoid arthritis) or Hodgkin's lymphoma (lymphogranulomatosis).
Accurately differentiate the diagnosis: heart attack, acute appendicitis, signs of ectopic pregnancy or osteoarthritis.
Ascertain the hidden forms of the disease in the human body.

If the analysis is normal, then an additional examination and tests are still prescribed, since a normal level of ESR does not exclude a serious disease in the human body or the presence of malignant neoplasms.

Norm indicators

The norm for men is 1-10 mm / h, for women on average - 3-15 mm / h. After 50 years, this figure can increase. During pregnancy, sometimes the rate can reach 25 mm / h. Such figures are explained by the fact that a pregnant woman has anemia and her blood thins. In children, depending on age - 0-2 mm / h (in newborns), 12-17 mm / h (up to 6 months).

The increase, as well as the decrease in the rate of red cell sedimentation for people of different ages and gender, depends on many factors. In the course of life, the human body is exposed to various infectious and viral diseases, which is why an increase in the number of leukocytes, antibodies, and erythrocytes is noticed.

Why ESR in the blood is higher than normal: causes

So, why is an elevated ESR detected in a blood test, and what does this mean? The most common cause of high ESR is the development of inflammatory processes in organs and tissues, which is why many perceive this reaction as specific.

In general, the following groups of diseases can be distinguished, in which the rate of sedimentation of red blood cells increases:

Infections. A high ESR accompanies almost all bacterial infections of the respiratory tract and genitourinary system, as well as other localizations. This is usually due to leukocytosis, which affects the aggregation features. If the leukocytes are normal, then it is necessary to exclude other diseases. In the case of the presence of symptoms of infection, it is likely to be viral or fungal in nature.
diseases, in which there is not only an inflammatory process, but also decay (necrosis) of tissues, blood cells and the entry of protein breakdown products into the bloodstream: purulent and septic diseases; malignant neoplasms; , lungs, brain, intestines, etc.
ESR increases very strongly and remains at a high level for a long time with autoimmune diseases. These include various thrombocytopenic purpura, rheumatic and scleroderma. Such a reaction of the indicator is due to the fact that all these diseases change the properties of blood plasma so much that it is oversaturated with immune complexes, making the blood defective.
Diseases of the kidneys. Of course, with an inflammatory process that affects the renal parenchyma, the ESR value will be higher than normal. However, quite often an increase in the described indicator occurs due to a decrease in the level of protein in the blood, which in high concentration goes into the urine due to damage to the renal vessels.
Pathologies metabolism and endocrine sphere- thyrotoxicosis.
Malignant rebirths bone marrow, in which erythrocytes enter the bloodstream, not being ready to perform their functions.
Hemoblastosis (leukemia, lymphogranulomatosis, etc.) and paraproteinemic hemoblastoses (multiple myeloma, Waldenström's disease).

These causes are most common with a high level of erythrocyte sedimentation rate. In addition, when passing the analysis, all the rules for conducting the test must be observed. If a person has even a slight cold, the rate will be increased.

Women, due to hormonal and physiological changes during the menstrual cycle, pregnancy, childbirth, breastfeeding and menopause, are more likely to undergo a qualitative and quantitative change in the content of dry residues in the blood. These reasons can cause an increased ESR in the blood in women up to 20-25 mm / h.

As you can see, there are a lot of reasons when the ESR is above the norm, and it is problematic to understand what this means only from one analysis. Therefore, the assessment of this indicator can only be entrusted to a truly knowledgeable specialist. You should not do something yourself that cannot be correctly determined with certainty.

Physiological causes of increased ESR

Many people know that an increase in this indicator, as a rule, indicates some kind of inflammatory reaction. But this is not a golden rule. If an elevated ESR in the blood is found, the causes can be quite safe and do not require any treatment:

dense meal before the test;
fasting, strict diet;
menstruation, pregnancy and the postpartum period in women;
allergic reactions, in which fluctuations in the initially increased erythrocyte sedimentation rate
allow us to judge the correct anti-allergic therapy - if the drug works, then the indicator will gradually decrease.

Undoubtedly, it is very difficult to determine what this means just by the deviation of one indicator from the norm. An experienced doctor and an additional examination will help to understand this.

Elevation above 100 mm/h

The indicator exceeds the level of 100 m/h in acute infectious processes:

Flu;
Pneumonia;
Tuberculosis;
Viral hepatitis;
Fungal infections;
malignant formations.

A significant increase in the norm does not occur immediately, the ESR grows for 2-3 days before it reaches a level of 100 mm / h.

False increase in ESR

In some situations, changes in indicators indicate not a pathological process, but some chronic conditions. The level of ESR can increase with obesity, an acute inflammatory process. Also, false changes in ESR are observed:

At .
Due to the use of oral contraceptives.
Subsequent vaccination against hepatitis B.
With long-term use of vitamins, which include a large amount of vitamin A.

Medical studies show that often for no reason ESR can increase in women. Doctors attribute such changes to hormonal disruptions.

Increased ESR in a child: causes

Increased soy in the blood of a child is most often caused by inflammatory causes. You can also identify such factors that lead to an increase in the erythrocyte sedimentation rate in children:

metabolic disease;
getting injured;
acute poisoning;
autoimmune diseases;
stressful state;
allergic reactions;
the presence of helminths or sluggish infectious diseases.

In a child, an increase in the erythrocyte sedimentation rate can be observed in case of teething, unbalanced nutrition, lack of vitamins. If children complain of malaise, in this case, you should consult a doctor and conduct a comprehensive examination, the doctor will determine why the ESR analysis is increased, after which the only correct treatment will be prescribed.

What to do

It is not advisable to prescribe treatment with an increase in the erythrocyte sedimentation rate in the blood, since this indicator is not a disease.

Therefore, in order to make sure that there are no pathologies in the human body (or, on the contrary, they take place), it is necessary to schedule a comprehensive examination, which will give an answer to this question.

Often in the clinic you can hear that you need to do an analysis for ESR in the blood. What is this indicator and what role does it play in the diagnosis of various diseases? This abbreviation stands for erythrocyte sedimentation rate. This indicator may deviate from the norm in various pathologies. The analysis is the first diagnostic step in case of hospital treatment or the need for surgery.

Description of the analysis

What is SOE? The ESR index indicates the erythrocyte sedimentation rate. During the laboratory analysis, the blood collected from the patient is left for a certain time in a vertically located test tube. Erythrocytes are heavier than plasma, so after a certain time they settle to the bottom, forming a red precipitate. It is this time that specialists detect in order to assess the ESR. The speed will be indicated in mm for 1 hour of time.

What is ROE? More recently, this was the name of the familiar analysis of ESR. Doctors called it ROE - the reaction of erythrocyte sediment. Today you can still find this name in the forms of individual laboratories.

Norms of indicators

If you received a form with an ROE indicator, now you know that this is the same as the ESR. The rate of ROE in the blood depends on the gender and age of the patient. Today, the following indicators should be considered as the norms of erythrocyte sedimentation time:

The ROE indicator can increase with a protein imbalance in the body. The main reasons for the increase in erythrocyte sedimentation rate are elevated levels of globulins and fibrinogen. Today, doctors use two main methods for determining ESR in the blood.

Diagnostic methods

Modern doctors use the following methods for determining ESR. ROE in the blood is determined by two methods. The most accurate is the Westergren method. The main difference of this method is that the erythrocyte sedimentation rate in the blood is estimated on a more accurate scale. In addition, the patient's blood is taken from a vein. Blood is mixed with an anticoagulant in a test tube. Measurement is carried out exactly one hour later, which gives the correct settling in mm / h.

However, despite the accuracy of the previous method in our country, the method of determining the erythrocyte sedimentation rate of ESR Panchinkov is more popular. Determination of ESR by this method requires taking blood from a patient's finger.

The erythrocyte sedimentation reaction is carried out in a special tube, marked with a scale in millimeters.

An anticoagulant is added to the blood on a special glass, after which the blood is drawn into a tube. After an hour, the indicator is evaluated and indicated by mm / h. The ESR formula is quite simple and does not require specialists to use additional equipment. After all, ESR ROE is what? It's just the rate of sedimentation of blood cells.

The sedimentation of erythrocytes by this method occurs in several stages:

In the first minutes after the addition of an anticoagulant to the blood, vertical columns of erythrocytes are formed. They are called coin columns.
Further, within 40 minutes, the erythrocytes settle.
After this period, the stage of cell compaction begins. It takes 10 minutes.

Thus, the time of the ESR mechanism takes 1 hour. This gave the name to the units of measurement of ESR mm / h. This methodology for assessing ESR is used everywhere in our country. The analysis can be taken at any clinic, the results are usually ready the next day.

Deviations from the norm in the direction of increase

It should be noted right away that ESR hematology may deviate from the norm due to physiological reasons. This is especially true for women. In the fairer sex, ESR indicators may increase in the postpartum period and on the days of menstruation. For this reason, these days it is better not to take the analysis. There are also people whose ESR is elevated from birth. This is not considered a pathology, and they can live with it for many years, and at the same time be completely healthy. But there are no more than 5% of such people on the planet. In addition, the erythrocyte content in the blood affects the sedimentation rate. With anemia of various nature, the rate increases.

If the ESR value is not increased due to physiological reasons, the presence of the following pathologies in the body can be assumed:

Inflammatory diseases.
body intoxication.
Infectious diseases.
Acute heart disease.
Injuries of a different nature.
Oncological diseases.
Pathology of the kidneys.
Anemia.

Thus, we can say that any serious pathology in the body is accompanied by an accelerated ESR. In addition, drug therapy with certain drugs can accelerate ESR.

Downward deviations from the norms

If your clinical value shows too slow a response, it may be due to an unbalanced or poor diet. Of the pathological causes, dehydration of the body and muscular dystrophy can be distinguished. In addition, the erythrocyte sedimentation rate can be influenced by their shape. This pattern is observed in crescent and stellate erythrocytes.

How to take an analysis

Setting the ESR does not require special preparatory actions from the patient. Preparation for analysis includes the standard refusal to eat for 8 hours before the analysis, a ban on drinking alcohol for a week and a decrease in physical activity the day before blood sampling. Remember that ESR and ROE are the same, so if your form contains the designation ROE, do not get confused and know that this is an erythrocyte sediment reaction.

How to reduce the rate

Treatment of accelerated ESR is simply not possible at home. There are no drugs or folk methods to reduce these rates. After all, what does the increase in performance indicate? It only says that some pathological process is taking place in the body, which develops and requires treatment. Only a doctor will be able to determine for what reasons your analysis showed deviations from the norm.

With the help of complex diagnostics and decoding of all indicators of your blood, the specialist will identify the disease and prescribe adequate treatment.

Today, doctors say that erythrocyte sedimentation often deviates from the norm for various physiological and third-party reasons. It is precisely because of the instability of this indicator that it is not always possible to talk about the presence of a terrible disease in the body. So, for example, in children, an increase in ESR, what does this say? If the child is healthy, the rise may show banal teething.

What does elevation mean in adults? Often, in adults, analysis indicators are increased from taking medications, with diets, lack of vitamins, and from other third-party factors. For this reason, the ESR analysis is not an accurate diagnostic method, and if the indicators deviate from the norm, additional diagnostics are necessary.

What to do if the cause of deviations is not identified

High ESR for no apparent reason, what does it mean? Often, patients have an increase in ESR, but doctors cannot determine the cause of this deviation. In this case, deviations should not be attributed to laboratory error or physiological factors. The best solution in this situation would be to undergo a complete examination of the body in order to exclude the presence of hidden pathological processes. Often, ESR can rise with oncology, which still does not manifest itself. Doctors recommend not to refuse additional diagnostics, because diseases detected in the early stages can be successfully treated.

However, there are times when the cause of a chronic increase in ESR remains a mystery to the doctor and patient. In this case, no therapy is carried out, because if the cause is not identified, there is simply nothing to treat. For such patients, doctors recommend regularly visiting a doctor, taking tests and monitoring the level of ESR at least 2 times a year.

If you have found an increase in the rate of erythrocyte sedimentation, there is no need to panic. Most often, deviations in the level of ESR are not a sign of fatal diseases. As well as other blood indicators, this analysis can give deviations for various, not always pathological reasons. The fact is that the blood reacts very quickly to any external and internal changes. Even a change in the weather leads to the fact that some changes may be detected in the analysis.

In contact with

General blood analysis prescribed for almost all diseases, during pregnancy and as a preventive measure to detect diseases. A general blood test is taken from a finger.

General blood analysis includes the determination of hemoglobin concentration, the number of erythrocytes, leukocytes and platelets, hematocrit and erythrocyte indices (MCV, MCH, MCHC).

Indications for a general blood test and ESR

A complete blood count, together with a leukocyte formula, is widely used as one of the most important examination methods for most diseases. The changes occurring in the peripheral blood are nonspecific, but at the same time reflect the changes occurring in the whole organism.

The study of the leukocyte formula is of great importance in the diagnosis of hematological, infectious, inflammatory diseases, as well as in assessing the severity of the condition and the effectiveness of the therapy. At the same time, changes in the leukocyte formula are not specific - they may have a similar character in different diseases or, on the contrary, dissimilar changes may occur in the same pathology in different patients. The leukocyte formula has age-specific features, so its shifts should be assessed from the position of the age norm (this is especially important when examining children).

Erythrocyte sedimentation rate (ESR):

Inflammatory diseases.
Infections.
Tumors.
Screening examination during preventive examinations.

Measurement of ESR should be considered as a screening test that is not specific to any particular disease. ESR is usually used in the complex of a complete blood count.

Preparation for a general blood test and ESR

A general blood test is performed on an empty stomach. Between the last meal and blood donation for a general analysis, at least 8 hours must pass. It is advisable to exclude fatty, fried and alcohol from the diet 1-2 days before the examination. One hour before taking blood, you must refrain from smoking.

It is necessary to exclude factors that affect the results of the research: physical stress (running, climbing stairs), emotional arousal. Before the procedure, you need to rest for 10-15 minutes, calm down.

Be sure to tell your doctor about taking medications.

Blood should not be donated after x-rays, rectal examinations, or physical therapy procedures.

Different laboratories may use different test methods and units of measurement. In order for the evaluation of the results to be correct, we recommend that you undergo studies in the same laboratory, at the same time. Comparison of such results will be more comparable.

Deciphering the general blood test

Modern hematological analyzers make it possible to obtain accurate and highly informative characteristics of blood cells.

Any changes in the general blood test and deviations from the norm are interpreted as pathological and require a thorough examination of the patient. Changes in the hemogram in many diseases can be nonspecific. In this case, they are used for dynamic monitoring of the patient and in terms of assessing the prognosis.

In diseases of the hematopoietic system, the study of a complete blood count becomes of paramount diagnostic importance. It determines the further strategy for examining the patient with the subsequent choice of treatment regimen and is necessary for monitoring ongoing therapy.

In hematology analyzers from various manufacturers, normal blood counts can vary significantly depending on the standards used in a particular country. The following are normal peripheral blood counts in adults according to the order of the Ministry of Health of the Russian Federation.

Norms of blood parameters

Blood index	Normal values
Hemoglobin, g/l Men Women	130,0-160,0 120,0-140,0
Erythrocytes (RBC), *1012/l Men Women	4,0-5,0 3,9-4,7
Hematocrit, % Men Women	40-48 36-42
Average content of hemoglobin in an erythrocyte (MCH), pg	27,0-31,0
Mean erythrocyte volume (MCV), fl, µm3	80,0-100,0
Mean erythrocyte hemoglobin concentration (MCHC), g/dL	30,0-38,0
Distribution width of erythrocytes by volume (RDW-CV), %	11,5-14,5
Reticulocytes, ‰ (or %)	2,0-12,0 (0,2-1,2)
Leukocytes, *109/l	4,0-9,0
Neutrophils, % (109/l) stab Segmented	1,0-6,0 (0,04-0,30) 47,0-72,0 (2,0-5,5)
Eosinophils	0,5-5,0 (0,02-0,3)
Basophils	0-1,0 (0-0,065)
Lymphocytes	19,0-37,0 (1,2-3,0)
Monocytes	3,0-11,0 (0,09-0,6)
Platelets, *109/l	180,0-320,0
Mean platelet volume (MPV), fl	7,4-10,4
Platelet distribution width by volume, (PDW), %	10-20
Thrombocrit (PCT), %	0,15-0,40
ESR, mm/h	2,0-20,0

Erythrocyte indicators (parameters) of blood

red blood cells
Erythrocytosis
Hemoglobin
Hematocrit
Average erythrocyte volume
The average content of hemoglobin in an erythrocyte
The average concentration of hemoglobin in the erythrocyte
The indicator of anisocytosis (heterogeneity) of erythrocytes (RDW - red cell distribution width)
Morphology of erythrocytes
Reticulocytes
Erythrocyte sedimentation rate (ESR level)

Platelet blood parameters

Platelets (PLT - platelet)
thrombocytosis
thrombocytopenia
Average platelet volume (MPV - mean platelet volume)
Platelet distribution width (PDW)
Thrombocrit (PCT - platelet crit)

Leukocyte blood parameters

White blood cell count
Neutrophils
Eosinophils
Basophils
Monocytes
Lymphocytes
Plasma cells
Atypical mononuclear cells

The leukocyte formula is the percentage of different types of leukocytes (neutrophils, lymphocytes, eosinophils, monocytes, basophils). The leukocyte formula includes the determination (in%) of neutrophils, lymphocytes, eosinophils, basophils, monocytes.

Erythrocyte sedimentation rate (ESR)

Erythrocyte sedimentation rate (ESR) is a non-specific indicator of inflammation.

ESR is an indicator of the rate of blood separation in a test tube with added anticoagulant into 2 layers: upper (transparent plasma) and lower (settled erythrocytes). The erythrocyte sedimentation rate is estimated by the height of the formed plasma layer (in mm) for 1 hour. 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, which occur at different rates. At first, erythrocytes slowly settle into individual cells. Then they form aggregates - "coin columns", and settling occurs faster. In the third phase, a lot of erythrocyte aggregates are formed, their sedimentation first slows down, and then gradually stops.

The ESR indicator varies depending on many physiological and pathological factors. The values of ESR in women are slightly higher than in men. Changes in the protein composition of the blood during pregnancy lead to an increase in ESR during this period.

A decrease in the content of erythrocytes (anemia) in the blood leads to an acceleration of ESR and, conversely, 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, contribute to the formation of "coin columns" and accelerated erythrocyte sedimentation.

An increase in acute phase proteins, for example, C-reactive protein, haptoglobin, alpha-1 antitrypsin, in acute inflammation leads to an increase in ESR. In acute inflammatory and infectious processes, a change in the erythrocyte sedimentation rate 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.

Westergren method differs from the common method for determining ESR in Panchenkov's device the characteristics of the tubes used and the scale of results calibrated according to the Westergren method. The results obtained by these two methods coincide in the range of normal values, both methods have the same reference values. The Westergren method is more sensitive to an increase in ESR, and the results in the zone of elevated values obtained by the Westergren method are higher than the results obtained by the Panchenkov method.

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.