ESR in the blood (sedimentation rate of erythrocytes)called the rate at which blood is split with the added anticoagulant in a test tube into two layers: the lower (settled red blood cells) and the upper (plasma). In this case, the height of the plasma layer formed in millimeters is estimated in one hour. In erythrocytes, the specific gravity is higher than that of plasma, so in the presence of sodium citrate (anticoagulant) they settle to the bottom under the influence of gravity.
What is ESR in the blood?The process of sedimentation (subsidence) specialists are divided into three phases, occurring at different rates. First, there is a slow drop in red blood cells to the bottom by individual cells. In the next stage, "coins" (aggregates) are formed, and the ESR in the blood increases. The last phase is characterized by the formation of a large number of aggregates of erythrocytes. Their fall slows down, and then stops.
The index of ESR in the blood can vary bythe impact of various pathological and physiological factors. In women, as medical practice shows, the values are slightly higher than the male rates.
During pregnancy, the increase in ESR in the bloodis due to a change in the protein composition of red blood cells. Reducing their concentration (anemia) helps to accelerate sedimentation, increasing their content, on the contrary, slows down the process. During the day, there is likely a fluctuation in the indicators. The highest level is typical for daytime.
Protein composition in blood plasma is the maininfluencing the formation of "coins" factor. Under the influence of acute phase proteins, the charge of erythrocytes decreases and they are repelled from each other. Thus, there is the formation of "coins" and accelerated sedimentation.
An increase in acute phase proteins, for example,haptoglobin, C-reactive protein, alpha-1-antitrypsin, against the background of acute inflammatory processes provokes an increase in ESR. In addition, with acute inflammation and infection, the change in the sedimentation index is observed 24 hours after an increase in the concentration of leukocytes and a rise in temperature. Against the background of chronic inflammation, the acceleration of subsidence is caused by a large number of immunoglobulins and fibrinogen.
Measurement of the ESR index is considered inas a screening test that does not have specificity for any particular pathology. This type of study, as a rule, is used in the complex of UAC (general blood test).
Indications for the purpose of the study are inflammatory processes, tumors, infections, as well as screening tests against the background of preventive examinations.
Blood sampling is performed on an empty stomach.
The increase in the physiological ESR index is observed in old age, in pregnant women, after childbirth, and during menstruation.
The pathological acceleration of subsidence is revealed whenintoxication, inflammation, chronic and acute infections (tuberculosis, osteomyelitis, syphilis, pneumonia). Elevated indices are also observed with myocardial infarction, autoimmune diseases, fractures, bone injuries, after operations, in shock, with anemia, and with the taking of certain medications. Acceleration of sedimentation can indicate kidney disease, hyperfibrinogenemia. The increased ESR in oncology is revealed. However, according to many experts, the indicator directly with a malignant neoplasm is not connected.
The slowdown of ESR is observed with a decrease in massmuscle, starvation, during the intake of corticosteroids, in the first and second trimesters of pregnancy, with myodystrophy, hyperhydration, and with a vegetarian diet.
