If the soe is normal, it means healthy. Increased ESR in the blood in women. Increased ESR - what to do.

Complete blood count is the most common method laboratory research blood. The results of this analysis clearly and accurately show her picture. By examining the results of a complete blood count, the doctor can explain the causes of the symptoms that disturb the patient, identify various diseases blood.

This test requires a small amount of capillary blood, which is usually taken from the ring finger. This analysis does not require special preparation from the patient, but it is best to take it in the morning and on an empty stomach, then the blood picture will be more clearly visible. The doctor makes a small puncture with a scarifier (this is such a blade-like tool).

The first drop of blood must be removed with a sterile cotton swab, because this drop contains epithelial cells, bacteria from the surface of the skin, etc. The laboratory assistant collects the rest of the blood in a test tube using a special long pipette. The resulting blood is sent for analysis.

A blood test is carried out either by a specially trained laboratory assistant, or a special device that produces a result in the form of a printout, which indicates all the necessary values. The decoding of the analysis is carried out directly by the doctor.

RBC count
The first place in this analysis is occupied by the number of erythrocytes - RBC. Erythrocytes are red blood cells that perform the function of oxygenation (transfer of oxygen and carbon dioxide). The norm of this indicator for men is 4.3-6.2x1012 / l, and for women and children - 3.8-5.5x1012 / l (1012 is 10 to the 12th degree).

An increase in this indicator indicates thickening of the blood, which can cause increased blood pressure, agglutination of red blood cells and lack of oxygen in the air. Decreased red blood cell count leads to anemia and oxygen starvation fabrics.

Hemoglobin
A special protein contained in red blood cells is responsible for the binding of oxygen and carbon dioxide. It's called hemoglobin (HGB). This is the second indicator in the general blood test. Its norm is 120-140 g / l. A decrease in this indicator gives the same symptoms as a decrease in the number of red blood cells, and its increase can signal dehydration of the body, a decrease in the number of red blood cells, and recent blood loss.

Hematocrit
An important indicator is hematocrit (HCT) - this is a numerical expression of the number of red blood cells in the total volume of blood. The normal value of this indicator is 39-49% for men and 35-45% for women. An increase in this indicator indicates an increase in the number of red blood cells and all the symptoms arising from this, the same applies to a decrease in the hematocrit value.

These are the main indicators regarding red blood cells, they give the most complete picture of red blood. In addition to these indicators, the analysis reflects the width of the distribution of erythrocytes (RDWc, the norm is 11.5 - 14.5%), the average volume of the erythrocyte (MCV, the norm is 80 - 100 fl), the average content of hemoglobin in the erythrocyte (MCH, the norm is 26 - 34 pg), the average concentration of hemoglobin in the erythrocyte (MCHC, the norm is 30 - 370 g / l). Doctors require the value of these indicators only in very severe cases.

Platelet count
Another valuable indicator is the number of platelets - platelets (PLT). These blood cells perform a very important function - they are involved in blood clotting in case of damage to blood vessels. The normal value of this indicator ranges from 180-320x109 / l (109 is 10 to the 9th degree).

An increase in this value indicates a recent loss of blood, after operations or after the removal of the spleen (the spleen is involved in the destruction of old platelets). A decrease in this indicator is observed in aplastic anemia, thrombocytopenic purpura (increased destruction of platelets), cirrhosis of the liver, hemophilia, etc.

ESR
The liquid part of the blood is plasma. Her condition reflects the erythrocyte sedimentation rate or abbreviated ESR, ESR. This indicator allows you to indirectly determine the content of proteins in plasma. The normal value of this indicator for men is no more than 10 mm / h, for women - 15 mm / h. ESR is an auxiliary indicator, the increase of which occurs in the presence of inflammation in the body. Since at the same time the amount of inflammatory proteins in the plasma increases and the erythrocytes settle faster, the increase in ESR only indicates the presence of inflammation, but does not indicate the place where this process originated. In addition, ESR increases during pregnancy, during menstruation, in the presence of malignant tumors, etc. A decrease in this indicator is very rare and, as a rule, there is nothing wrong with that. The ESR norm depends on gender and age: in women, the natural level of ESR is higher than in men, and in older people it is higher than in young people. By the way, in 5% of people, ESR from birth does not fall within the normal range, but at the same time they are not sick with anything from the point of view of medicine.

Well, here we have considered the main indicators by which it is analyzed general analysis blood, soe norm, decoding of the analysis which they told. Now it’s a little easier for you to navigate by the considered indicators, while their combination allows the doctor to understand a lot and assess the state of the body as a whole. Remember that only a doctor will be able to tell you exactly what the laboratory interpretation of blood analysis means, the reasons for the increase or decrease in certain indicators and explain the occurrence of symptoms that bother you.

ESR - what is it? An exhaustive answer to question asked you will find in the materials of the presented article. We will tell you about what is the norm of this indicator in human blood, why it is determined, in what diseases it is observed, and so on.

General information about the indicator and decoding

Surely every patient who donated blood for tests saw the abbreviation ESR in the results. The decoding of the presented combination of letters is as follows: erythrocyte sedimentation rate.

In medical practice, this term is called laboratory non-specific, which reflects the ratio of plasma.

History of the research method

ESR - what is it? How long has this indicator been taken into account in the study of the material of the patient? This phenomenon was known in ancient Greece, but it was not used in clinical practice until the twentieth century.

In 1918, it was found that the erythrocyte sedimentation rate differed significantly between pregnant women and ordinary people. Subsequently, scientists have revealed the fact that this indicator changes under the influence of certain diseases. Thus, in the period from 1926 to 1935, several research methods were developed, which are still actively used in medical practice to determine the ESR value.

The principle of the research method

ESR - what is it, and how is this indicator determined? To determine the value of the patient, it is necessary to donate blood for analysis. As a result of her research, laboratory staff determine the specific mass of red cells. If they exceed the specific gravity of the plasma, then the erythrocytes begin to slowly settle to the bottom of the tube. This is how the rate and degree of aggregation (the ability to stick together) of red blood cells is determined.

Chemical causes of an increase and decrease in the erythrocyte sedimentation rate

The ESR index directly depends on the degree of erythrocyte aggregation. However, it increases if the plasma concentration of acute phase proteins or markers increases. inflammatory process. Conversely, the ESR value decreases if the amount of albumin increases.

ESR analysis: the norm of the indicator

As mentioned above, in order to determine the patient, it is necessary to donate blood for analysis. After the material enters the laboratory, it is subjected to a thorough examination. Specialists observe the process of erythrocyte sedimentation under the influence of gravity, depriving the blood of any possibility of clotting.

So what should be normal ESR indicator? The rate of sedimentation of red blood cells in healthy women is 2-15 mm per hour. As for the representatives of the stronger sex, this value is somewhat lower for them and equals 1-10 mm per hour.

ESR: indicator level

In medical practice, deviations from the norm are usually distinguished by degrees:

Possible causes of deviations from the norm

Now you know the information about ESR - what it is. Most often, an increase in this indicator is associated with chronic or acute infection, heart attacks. internal organs and immunopathological diseases.

Despite the fact that inflammatory reactions in the body are the most common causes acceleration of erythrocyte sedimentation, this deviation may be due to other, not always pathological, phenomena.

A significant increase in ESR is observed in malignant neoplasms, a decrease in the total number of erythrocytes, during pregnancy, and also during treatment with any medicines(for example, salicylates).

A moderate increase in ESR (by about 20-30 mm per hour) can occur with hypoproteinemia, anemia, pregnancy, and also in women during menstruation.

Diseases with increased or decreased ESR

Sharp and significant red cells (more than 60 mm per hour) are accompanied by conditions such as autoimmune diseases, septic process and malignant tumors characterized by tissue breakdown.

A reduced value of this indicator is possible with changes in the shape of erythrocytes, hyperproteinemia, leukocytosis, erythrocytosis, as well as hepatitis and DIC.

Why is it important to conduct a blood test for ESR?

Despite the nonspecificity of the definition of ESR, this study remains the most popular and important laboratory test. Thanks to him, specialists can quickly establish the fact of the presence and intensity of the development of the inflammatory process.

Such a study of the patient's blood often reveals malignant neoplasm, which allows you to start to eliminate it in time and save the life of the patient. That is why the definition of ESR is extremely important method research, which is subjected to the blood of almost every person who seeks help from a medical institution.

A complete blood count is the type of study with which any laboratory diagnosis begins. And in this analysis, along with many indicators (the number of red blood cells, white blood cells, hemoglobin levels), ESR appears. What is SOE? This abbreviation stands for erythrocyte sedimentation rate.

The essence of the method

Our blood consists of a liquid part and a dry residue. The liquid part of the blood is plasma, and the dry residue is mainly represented by erythrocytes. In addition to erythrocytes, there are also leukocytes and platelets. But their number is so small that it can not be taken into account. Erythrocytes, or red blood cells, are biconcave discs.

In order for erythrocytes to perform their main function of transporting oxygen and carbon dioxide, they must be in the blood plasma in a free suspended state, and in no case should they stick together. This is achieved by a number of complex physiological mechanisms. However, in vitro (in vitro) erythrocytes settle because their density, or specific gravity, exceeds the density of blood plasma. True, the speed of their settling is different.

Not the last factor affecting the rate is the phenomenon of erythrocyte aggregation (gluing). RBC aggregation is a consequence of various pathological conditions. Conglomerates of erythrocytes glued together have a large mass with a relatively small surface area, which creates conditions for their faster settling in a liquid medium.

Influencing factors

ESR in the blood depends on a number of factors, including:

1. The charge of the erythrocyte membrane. Normally, the surface of the erythrocyte membrane has a negative charge. Similarly charged erythrocytes repel each other and do not stick together. Due to various pathological conditions (poisoning, infection, diseases of internal organs), the erythrocyte membrane can be damaged with a change in its charge.
2. The number of erythrocytes. The fewer red blood cells, the faster they settle, and vice versa. Therefore, with anemia (anemia), the ESR will be increased.
3. The protein composition of the blood. The main proteins of blood plasma are represented by low molecular weight albumins and large molecular weight globulins. With various inflammatory reactions, incl. and infectious nature, the amount of globulins increases. “Inflammatory proteins” appear - fibrinogen, C-reactive protein. This is accompanied by a change in the membrane charge of erythrocytes. A decrease in albumin levels in liver disease leads to the same result.
4. Acid-base state of the blood (ACS). The higher the acidity (acidosis) of the blood plasma, the higher the ESR, and, conversely, when the CBS is shifted to the alkaline side (alkalosis), the ESR increases.

Thus, ESR shows that certain pathological changes occur in various organs and biological environments.

Normal values

The unit of measurement of ESR is mm/h - millimeter per hour. When determining the ESR norm, the following are taken into account:

2. Floor. In men ESR norm is 2-10 mm / h, and in women it is slightly higher, and is equal to 3-15 mm / h.
4. Age. In persons of both sexes older than 50-60 years, the upper limit of values ​​\u200b\u200bis up to 15-20 mm / h is allowed. ESR changes especially rapidly in children different ages. In newborns, ESR is 0-2 mm / h, in children from 6 months to a year - 12-17 mm / h, and in the blood of a child older than a year - 12-18 mm / h.

Although various sources normal values ESR may vary slightly. Apparently, this is due to the improvement of the technology for measuring this indicator.

In some reference materials you can meet another indicator - ROE. This is the erythrocyte sedimentation reaction.

The presence of this indicator in some cases can confuse the interpretation of the test results. However, it should be noted that ESR and ROE are one and the same. It's just that ROE is an outdated term, which was replaced by ESR back in Soviet times.

Method of determination

The classic method for determining ESR is the Panchenkov method. capillary blood taken from the finger of the subject, in order to avoid clotting, it is mixed with a preservative in a ratio of 3: 1 - 3 parts of blood and 1 part of a preservative. 5% sodium citrate acts as a preservative. The citrated blood is then placed into specially graduated glass capillaries. The results of the analysis are evaluated after 1 hour by the height of the light bar corresponding to blood plasma devoid of settled erythrocytes.

Now the Panchenkov method has been replaced by a more progressive method Westergren. At its core, it practically does not differ from the Panchenkov method. True, here, instead of glass capillaries, special graduated test tubes are used. The concentration of the preservative and its ratio with blood is also different - 3.8% and 4:1. But the fundamental difference is different. When determining ESR according to the Westergren method, instead of blood from a finger, blood is taken from a vein. The bottom line is that many external influences (cold, physical activity) lead to capillary spasm, to a change in the characteristics of the blood flowing in them, and to a distortion of the results obtained. It follows from this that the analysis of venous blood is more objective than that of arterial blood.

Causes of high ESR

In clinical practice, an increase in ESR is most often observed. The main reasons for this standing:

• inflammatory processes in the upper respiratory tract infectious nature - sinusitis, pharyngitis, rhinitis, tonsillitis;
• liver diseases - hepatitis, cirrhosis;
• malignant oncological diseases - cancer, sarcoma;
• allergic reactions;
• anemia;
• various conditions leading to alkalosis;
• pregnancy;
• increased blood cholesterol levels;
• abundant intake of fatty foods - in this regard, a complete blood count should be taken on an empty stomach.

ESR may increase during blood sampling in hot climates, at temperatures above 270C. And this should also be taken into account when evaluating the results.

Causes of low ESR

A decrease in ESR may be due to such reasons as:

• polycythemia - a disease that leads to an increase in the content of red blood cells in the blood;
• diseases of the cardiovascular system, leading to the formation of congestive heart failure;
• some genetic blood diseases - sickle cell anemia, hereditary microspherocytosis;
• plasma acidosis;
• taking certain medications, including non-steroidal anti-inflammatory drugs;
• an increase in the level of bile acids in the blood plasma with liver damage, inflammatory diseases gallbladder, pancreas;
• Low ESR is also observed when blood is taken for analysis with an ambient temperature below 220C.

Features of the increase in certain conditions

Depending on the pathology, 3 degrees of increased ESR are distinguished:

1. 15-30;
2. 30-60;
3. over 60.

It is believed that the degree of increase in this indicator depends on the severity of the inflammatory process. In this regard, the ESR in pneumonia will be higher than in bronchitis. Although this statement is not always true. ESR level depends on the phase of the disease. As a rule, it rises 1-2 days after the first symptom of the disease has developed - weakness,
Cough or high fever.

The maximum value of ESR is reached approximately at the 2nd week of the disease. Together with ESR, the number of leukocytes increases. Then, as the patient's condition improves during treatment, the ESR decreases and returns to normal. During pregnancy, an increase in ESR occurs approximately from the 4th week, reaches a maximum by the end of pregnancy (40-50 mm / h and above), and after successful delivery it quickly normalizes. In oncology, due to the massive breakdown of the protein, the composition of the blood plasma changes, and this is accompanied by a sharp increase in ESR up to 80-90 mm/h.

Clinical Significance

It should be noted that it is impossible to judge the severity and phase of the course of the disease on the basis of ESR alone. This is a non-specific indicator, and the decoding of the analysis, in addition to the ESR, should take into account the content of other uniform elements. Most often, a high ESR in the general blood test is the reason for a more detailed laboratory diagnosis.

A general clinical blood test, or its general analysis, is the most common type of diagnostic procedure. The ease of its implementation, combined with excellent information content, make it an indispensable attribute of any treatment and diagnostic process. One of the indicators of this analysis is the erythrocyte sedimentation rate (ESR). It acts as a very ambiguous criterion for assessing the state of human health and therefore requires a special approach and knowledge for its correct interpretation.

What is the ESR indicator and what does its increase indicate

The rate or reaction of erythrocyte sedimentation is the ability of these cellular elements of the blood to settle to the bottom of the test tube under the influence of gravity. In this case, the blood plasma is deprived of all coagulation factors. This is necessary in order to exclude the influence of the blood coagulation system on the formation of an erythrocyte clot. It turns out that the ESR reflects exclusively the relationship between blood plasma proteins and its cellular elements. Similarly, the value of this indicator is affected by qualitative changes in the protein composition of blood plasma. This means that changes in both the first and second ones can affect the ability of erythrocytes to settle.

In a healthy body, each erythrocyte has a certain charge, which allows these cells to circulate freely in the microvascular bed. Indeed, in this case, they repel each other, passing through the smallest capillaries. If under the influence of certain factors there is a violation of the charge potential of red blood cells, they begin to collide with each other. In this case, their conglomerates are formed. Naturally, such blood, being in a test tube in a vertical position, forms a precipitate much faster. Therefore, the recorded erythrocyte sedimentation rate will be higher than normal values.

It is logical that the units of measurement of ESR are the number of millimeters per hour (mm / h). The norm of this indicator differs in men and women, ranging from 1 to 10 and from 2 to 15, respectively. Therefore, the acceleration of erythrocyte sedimentation can be not only pathological, but also be of a completely physiological nature.

Increased ESR as an indicator of disease

Many physicians use the Erythrocyte Sedimentation Rate as one of the powerful guides in the treatment of their patients. And most of them notice that it does not increase immediately after the onset of problems in the body, but is able to remain at this level for a long time. This is due to the fact that red blood cells that have broken their structure due to a certain pathology are not able to restore it back. Therefore, replacing them with new, healthy cells will solve this problem. It turns out that the more serious the pathological changes in the body were, the more erythrocytes and plasma factors acquired abnormal properties. They also need more time to recover.

There are many reasons for increasing the erythrocyte sedimentation rate. Therefore, you need to focus on those that have already taken place in the patient's history. If there are none, it is worth, first of all, to exclude oncological pathology and sluggish infections.

The adhesion of erythrocytes to each other is the main mechanism for accelerating ESR

ESR increase as a variant of the norm

In some cases, the detected increase in the erythrocyte sedimentation rate is not pathological, but is a natural manifestation of some features of the body. These include:

1. Female;
2. Childhood and senile age;
3. Prolonged fasting, diet therapy and fasting. Sometimes it can be exhaustion on the background of diseases;
4. Obesity more than 2 degrees;
5. Habitual minor anemia of unknown cause;
6. Reception vitamin preparations and the introduction of artificial plasma substitutes;
7. Hormone replacement therapy with combined oral contraceptives;
8. Pregnancy and the period of breastfeeding;
9. An increase in the number of globulin protein fractions in blood plasma, which happens after past infections and vaccinations.

An increased erythrocyte sedimentation rate in the blood is sure sign diseases and pathological changes in the body. But this indicator can be used to build a great diagnostic path for the detection and early treatment of life-threatening diseases.