What is ESR measured in mm h. Causes of increased ESR in the blood of a child and an adult

In a general clinical blood test, the abbreviation ESR (Latin equivalent - ESR) stands for erythrocyte sedimentation rate. The indicator does not relate to specific research parameters, but has important diagnostic value. The normal ESR level in the blood is graded according to the gender and age of the patient. Velocity can be measured using venous and capillary (from a finger) blood.

Another name for the indicator is ROE (erythrocyte sedimentation reaction). The term is considered obsolete, but continues to be used in some laboratories. The formulation used by patients - the norm of POE in the blood (or SOE) - is incorrect and has no relation to medical research.

Indicator value

The components of the cellular part are:

• colorless cells or leukocytes, including five varieties: neutrophils, lymphocytes, basophils, monocytes, eosinophils;
• blood platelets - platelets;
• red cells are erythrocytes.

The responsibilities of red blood cells include moving oxygenated hemoglobin through the bloodstream from the lungs to the body tissues and transporting it in the opposite direction. This interaction of hemoglobin and blood cells ensures oxygen supply, stability of the acid-base state and constancy of the internal environment (homeostasis) of the body.

Reference! Hemoglobin is a two-component iron-containing protein with the function of capturing oxygen molecules in the lungs and delivering it to tissues using red blood cells. Freed from the oxygen component, hemoglobin attracts carbon dioxide molecules, and red blood cells transport it in the opposite direction for disposal.

Red blood cells are the heaviest of all blood cells. In addition, they have the property of sticking together, which further increases the red blood cell mass. The rate of erythrocyte sedimentation is influenced by the constituent elements of the blood flow:

• plasma proteins (albumin, fibrinogen, globulins);
• number of red blood cells and hemoglobin concentration;
• level of free and direct bilirubin;
• concentration bile acids;
• cholesterol content;
• balance of acids and alkalis.

The level of ROE increases with an increase in the content of globulins and fibrinogen, characteristic of infections, oncological pathologies, and purulent-inflammatory processes. A decrease in albumin concentration accompanies inflammatory diseases renal apparatus, infectious and toxic liver damage, chronic diseases digestive system Indicators of the rate of precipitation of erythrocytes increase.

With erythrocytosis (increased number of red cells) and hyperhemoglobinemia (increased hemoglobin), the blood thickens, which slows down the erythrocyte sedimentation reaction. Thick blood is a sign of impaired cardiac and respiratory activity.

Erythropenia (deficiency of red cells) and hypohemoglobinemia, characteristic of anemia, increase ESR. High cholesterol, which accompanies atherosclerosis and diabetes, accelerates the sedimentation reaction.

ESR is a kind of indicator of inflammatory processes occurring in the body. During inflammation of any etiology, specific substances are formed that “force” red blood cells to actively stick together and quickly precipitate.

Indications for analysis and preparation

The ROE indicator is one of the parameters studied as part of a general blood test. OKA is considered the most common method of primary diagnosis of diseases. For the study, capillary blood is taken (from a finger). Before the procedure it is recommended:

• Eliminate fatty foods and alcohol from your diet in two days;
• on the eve of blood donation, reduce physical activity;
• observe a fasting regime of 8 to 12 hours.

High reliability of the results is ensured by biomaterial taken on an empty stomach. Indications for determining the erythrocyte sedimentation reaction and other parameters of blood composition:

• symptomatic complaints of the patient;
• control over the therapy;
• routine examination (pregnancy screening, clinical examination, intravenous examination, etc.).

ESR is included in the list of indicators to be assessed in case of emergency medical care(emergency surgery, trauma, injury, etc.).

ESR measurement

According to the method of measuring ESR indicators, two methods are distinguished, intended separately for capillary blood and separately for venous biofluid:

• according to Panchenkov's method. Blood taken from a finger is mixed with an anticoagulant reagent that prevents the clotting of the biofluid, and then it is drawn into a glass capillary (a tube with a scale of 100 divisions). An hour later, the height of the plasma freed from formed elements is assessed.
• according to Westergren. Venous blood is analyzed in a similar way. The measurement method is more accurate because it uses a scale with 200 divisions.

Sodium citrate is used as a reagent in both cases. When a test tube with blood and reagent is placed in a vertical position, after a certain time interval the biofluid will separate. There will be liquid plasma at the top, platelets and leukocytes in the middle of the tube, red cells will settle to the bottom.

The separation process takes one hour and consists of three stages:

• vertical accumulation of formed elements (about 10 minutes);
• settling of biological fluid (40 minutes);
• gluing and compaction of settled red cells.

The measurement value for the erythrocyte sedimentation reaction is millimeters per hour (mm/h). An hour is the time of separation of red cells from the plasma, mm is the height of the liquid part of the blood in a test tube.

Visual distribution of blood components in a glass tube

Reference values

The ROE norm accepted in clinical hematology is directly dependent on the reference values ​​of erythrocytes and hemoglobin. Male blood contains a higher concentration of red blood cells than female biomaterial.

This is due to hormonal differences and the higher physical endurance provided by nature. Male red blood cells take longer to stick together and settle, so the normal ESR in men is lower than in women.

Normal ESR in the blood of women

ESR values ​​in women during the perinatal period deserve special attention. Significant changes occur in the blood of pregnant women associated with changes in hormonal status and the need to ensure the viability of two organisms and the growth of the provisional organ (placenta). In addition, during the perinatal period, the concentration of fibrinogen increases and the albumin content decreases, which affects the level of ESR.

Standards for a pregnant woman according to Panchenkov (in mm/h)

By analogy with gender, reference values ​​are distributed in adults and children. The more red blood cells there are in the blood, the slower they precipitate. The slowest speed is in a newborn baby.

His blood contains a lot of red blood cells and hemoglobin, which is due to the peculiarities of intrauterine hematopoiesis. During the first month of life, the level of red blood cells and hemoglobin should decrease, and the ROE should accelerate.

What is the normal speed for newborn babies? In hematological pediatrics, the accepted rate is 1-2 mm/h - the same for full-term and premature babies. Until the age of six months, the ESR gradually increases to the norm of 4-6 mm/h.

Table of children's indicators (values ​​in mm/h)

The division of normative values ​​by gender begins in adolescents during puberty. From 13 to 15 years of age, erythrocyte sedimentation rate, red cell count, and hemoglobin levels are compared with those of an adult.

Deviation of indicators from the norm

A shift in the ESR level is, first of all, a change in the composition of the blood (the amount of cellular elements, components of plasma, hemoglobin, etc.). Deviation of the erythrocyte sedimentation reaction from normative values ​​occurs against the background of:

• acute conditions;
• sluggish latent inflammation and acute infectious and inflammatory diseases;
• chronic pathologies internal organs and systems.

In addition, ESR is influenced by physiological causes of blood disorders. Accelerated erythrocyte sedimentation and blood viscosity abnormalities are identified as a separate syndrome according to IBC 10.

Non-pathological factors

The rate of adhesion and sedimentation of red blood cells changes under the influence of factors of non-inflammatory origin.

Non-pathological causes

Acceleration of ROE	ROE slowdown
use of hormone-containing oral contraceptives	climatic conditions of residence (highlands)
distress (constant nervous tension)	intense sports or other physical activity
pregnancy, lactation, menstruation	gastronomic preferences for protein foods
hypodynamic lifestyle	nicotine addiction
eating behavior (passion for carbohydrate diets)	dehydration (dehydration of the body) due to overheating
overhydration (drinking too much fluid)
course treatment with anticoagulants (blood thinning drugs)
passion for alcoholic drinks

Accelerated red cell deposition may trigger the body's reaction to the hepatitis B vaccine.

Increased ESR in acute conditions

The ESR rate increases with the development of acute conditions requiring emergency medical intervention:

• excessive external bleeding due to injury, injury to soft tissues and bones;
• burns of a large surface of the skin;
• hemorrhoidal bleeding;
• internal hemorrhages in the abdominal and pleural cavity, brain, pericardium (connective tissue membrane of the heart), bladder etc.;
• severe intoxication (food, alcohol, chemical poisoning);
• myocardial infarction;
• rapidly developing suppuration and disruption of the integrity of internal organs (perforation);
• postoperative period.

The blood test in the listed cases is carried out in an abbreviated version.

Chronic pathologies with accelerated ROE

A high level of ESR accompanies a state of chronic disorders of the body:

• endocrine diseases(increased synthesis of hormones thyroid gland(hyperthyroidism and Basedow's disease), diabetes mellitus type 1 and 2);
• acute renal failure;
• hypercholesterolemia (cholesterol content is higher than normal);
• malignant neoplasms;
• autoimmune pathologies (reactive arthritis, systemic lupus erythematosus, Sjogren's syndrome, scleroderma, psoriasis);
• dysfunction of the bone marrow to produce blood cells (anaplastic anemia);
• inflammatory processes in the pyelocaliceal system and renal parenchyma (pyelonephritis);
• inflammatory diseases heart (myocarditis, pericarditis, endocarditis);
• necrotic lesions of the liver (cirrhosis), pancreas (pancreatic necrosis), gangrene, sepsis.

The normal level of ESR, as well as other blood parameters, is modified by chemotherapy treatment.

ESR in infectious and inflammatory diseases

• whooping cough;
• measles;
• parotitis;
• polio;
• rubella;
• chicken pox etc.

After treatment of an infectious disease, the number of leukocytes first normalizes, then the erythrocyte sedimentation rate slows down.

Important! If there is a persistent increase in ESR over a long period of time, the patient needs additional examination to identify secondary infectious complications or cancer.

Decreased erythrocyte sedimentation rate

Slow ROE is associated with blood thickening, a symptom characteristic of the following conditions:

• kidney pathologies (hydronephrosis, stenosis renal arteries, nephrotic symptom complex);
• heart disease (cardiomyopathy, ischemic heart disease - ischemic disease hearts), birth defects hearts,
• dysfunction respiratory system (bronchial asthma, obstructive pulmonary disease, pulmonary fibrosis and pneumosclerosis);
• acute leukemia, erythremia (a type of blood cancer, otherwise Vaquez-Osler disease);
• intestinal obstruction (complication of pathologies of the digestive system).

In analysis blood ESR is not a specific parameter by which the disease can be diagnosed. Accelerated erythrocyte sedimentation syndrome and blood viscosity abnormalities are grounds for additional examination.

Results

ESR or ESR is one of the parameters of a general clinical blood test. The abbreviation means erythrocyte sedimentation rate (red blood cells responsible for moving hemoglobin through the bloodstream to supply the body with oxygen).

Reference ESR values ​​are classified according to gender and age criteria. The average erythrocyte sedimentation rate is: for newborn children - from 2 to 2 mm/h, in preschool and school age– from 3 to 11 mm/h. During puberty, children's indicators are compared with adult norms and divided by gender.

Reference values ​​for an adult (according to the Panchenkov scale)

The results of the analysis are deciphered by the doctor, comparing the ESR data with other blood parameters. An increase in ESR levels indicates the presence of a chronic inflammatory or acute infectious process in the body.

The sedimentation of red blood cells accelerates during bleeding, during pregnancy, against the background of poor nutrition and alcoholism. High levels that persist for a long time are grounds for checking the patient for the presence of malignant diseases.

© Use of site materials only in agreement with the administration.

Previously, it was called ROE, although some still habitually use this abbreviation, now they call it ESR, but in most cases they apply the neuter gender to it (increased or accelerated ESR). The author, with the permission of the readers, will use the modern abbreviation (ESR) and feminine(speed).

1. Acute and chronic inflammatory processes of infectious origin (pneumonia, syphilis, tuberculosis,). Using this laboratory test, one can judge the stage of the disease, the subsidence of the process, and the effectiveness of therapy. The synthesis of “acute phase” proteins in the acute period and the enhanced production of immunoglobulins at the height of “military operations” significantly increase the aggregation abilities of erythrocytes and the formation of coin columns by them. It should be noted that bacterial infections give higher numbers compared to viral lesions.
2. Collagenosis (rheumatoid polyarthritis).
3. Heart lesions ( – damage to the heart muscle, inflammation, synthesis of “acute phase” proteins, including fibrinogen, increased aggregation of red blood cells, formation of coin columns – increased ESR).
4. Diseases of the liver (hepatitis), pancreas (destructive pancreatitis), intestines (Crohn's disease, ulcerative colitis), kidneys (nephrotic syndrome).
5. Endocrine pathology (, thyrotoxicosis).
6. Hematological diseases (,).
7. Injury to organs and tissues ( surgical operations, wounds and bone fractures) - any damage increases the ability of red blood cells to aggregate.
8. Lead or arsenic poisoning.
9. Conditions accompanied by severe intoxication.
10. Malignant neoplasms. Of course, it is unlikely that the test can claim to be the main diagnostic sign for oncology, but its increase will one way or another create many questions that will have to be answered.
11. Monoclonal gammopathies (Waldenström's macroglobulinemia, immunoproliferative processes).
12. High cholesterol ().
13. The impact of some medicines(morphine, dextran, vitamin D, methyldopa).

However, at different periods of the same process or under different pathological conditions, ESR does not change the same:

• A very sharp increase in ESR to 60-80 mm/hour is typical for myeloma, lymphosarcoma and other tumors.
• Tuberculosis in the initial stages does not change the erythrocyte sedimentation rate, but if it is not stopped or a complication occurs, the rate will quickly creep up.
• In the acute period of infection, the ESR will begin to increase only from 2-3 days, but may not decrease for quite a long time, for example, with lobar pneumonia - the crisis has passed, the disease recedes, but the ESR persists.
• This laboratory test is unlikely to help even on the first day. acute appendicitis, since it will be within normal limits.
• Active rheumatism can last for a long time with an increase in ESR, but without frightening numbers, but its decrease should alert you to the development of heart failure (acidosis).
• Usually, when the infectious process subsides, the total number of leukocytes returns to normal first (and remains to complete the reaction), ESR is somewhat delayed and decreases later.

Meanwhile, long-term persistence of high ESR values ​​(20-40, or even 75 mm/hour and above) in infectious and inflammatory diseases of any kind will most likely suggest complications, and in the absence of obvious infections, the presence of some then hidden and possibly very serious diseases. And, although not in all cancer patients the disease begins with an increase in ESR, its high level (70 mm/hour and above) in the absence of an inflammatory process most often occurs in oncology, because the tumor will sooner or later cause significant damage to the tissues, the damage of which will ultimately result. As a result, the erythrocyte sedimentation rate will begin to increase.

What could a decrease in ESR mean?

The reader will probably agree that we attach little importance to ESR if the numbers are within the normal range, but reducing the indicator, taking into account age and gender, to 1-2 mm/hour will still raise a number of questions for particularly curious patients. For example, a general blood test of a woman of reproductive age, when examined repeatedly, “spoils” the level of erythrocyte sedimentation rate, which does not fit into the physiological parameters. Why is this happening? As in the case of an increase, a decrease in ESR also has its own reasons, due to a decrease or lack of the ability of red blood cells to aggregate and form coin columns.

Factors leading to such deviations include:

1. Increased blood viscosity, which, with an increase in the number of red blood cells (erythremia), can generally stop the sedimentation process;
2. Changes in the shape of red blood cells, which, in principle, due to their irregular shape, cannot fit into coin columns (sickling, spherocytosis, etc.);
3. Changes in physical and chemical blood parameters with a shift in pH downward.

Such changes in the blood are characteristic of the following conditions of the body:

• (hyperbilirubinemia);
• Obstructive jaundice and, as a consequence, the release of large amounts of bile acids;
• and reactive erythrocytosis;
• Sickle cell anemia;
• Chronic circulatory failure;
• Decreased fibrinogen levels (hypofibrinogenemia).

However, clinicians do not consider a decrease in erythrocyte sedimentation rate to be an important diagnostic indicator, so the data is presented specifically for particularly inquisitive people. It is clear that in men this decrease is not noticeable at all.

It is definitely not possible to determine whether your ESR has increased without a finger prick, but it is quite possible to assume an accelerated result. Increased heart rate (), increased body temperature (fever), and other symptoms indicating the approach of an infectious-inflammatory disease can be indirect signs of changes in many hematological parameters, including the erythrocyte sedimentation rate.

Video: clinical blood test, ESR, Dr. Komarovsky

A blood test for erythrocyte sedimentation rate is one of the simple and cheap diagnostic methods. This sensitive test can detect the development of inflammation, infection or other disease at an early stage, when there are no symptoms. Therefore, the study of ESR is part of both routine medical examinations and one of diagnostic methods. To determine the exact cause of high ESR in the blood, it is necessary to conduct additional tests and medical examination.

Purpose of analysis

Blood tests are of great importance in medicine. They help establish the correct diagnosis and monitor the effectiveness of treatment. Situations when ESR in the blood is elevated are quite common in medical practice. This is not a reason to panic, because there are many reasons for changes in the erythrocyte sedimentation rate. The test indicates possible problems with health and is considered a reason to conduct additional research.

The result of an ESR study gives the doctor a lot of useful information:

• Serves as the basis for timely medical research (blood biochemistry, ultrasound examination, biopsy, etc.)
• As part of the diagnostic complex, it makes it possible to objectively judge the patient’s health and establish a diagnosis
• ESR readings over time help monitor the effectiveness of treatment and confirm the correctness of the diagnosis.

Permissible rate

The erythrocyte sedimentation rate is determined in the laboratory and measured in mm/h. The whole process takes one hour.

There are several research methods, but they are all built on the same principle.

A reagent is added to the tube or capillary containing the patient's blood sample to help separate the blood plasma from the red blood cells. Each red blood cell tends to settle at the bottom of the test tube. It measures how many millimeters the red blood cells have dropped within an hour.

The normal level of ESR depends on age and gender. For adult men, the normal level is 1-10 mm/h; for women, the normal level is above 2-15 mm/h. With age, the erythrocyte sedimentation rate can increase to 50 mm/h. For pregnant women, the norm rises to 45 mm/h; ESR normalizes only a few weeks or months after birth.

Indicator growth rate

For diagnosis, it is important not only the fact that the ESR is elevated, but also how much it exceeded the norm and under what circumstances. If a blood test is taken a few days after illness, the level of leukocytes and ESR will be exceeded, but this will be a slight increase caused by the development of immunity against infection. There are basically four degrees of high erythrocyte sedimentation reaction.

• A slight increase (up to 15 mm/h), at which other blood components remain normal. Possible availability external factors, affecting ESR.
• An increase of 16-29 mm/h indicates the development of infection in the body. The process may be asymptomatic and not significantly affect the patient’s well-being. So they can increase ESR colds and flu. With proper treatment, the infection dies, and the erythrocyte sedimentation level returns to normal after 2-3 weeks.
• A significant excess of the norm (30 mm/h or more) is considered dangerous for the body, as a result of which dangerous inflammations may occur, accompanied by necrotic tissue damage. Treatment of diseases in this case takes several months.
• Extremely high levels (more than 60 mm/h) occur in serious diseases in which there is a clear threat to the patient’s life. Immediate medical examination and treatment is required. If the level rises to 100 mm/h, the most likely cause of the violation is ESR standards oncological diseases.

Why does ESR increase?

A high level of ESR occurs when various diseases And pathological changes body. There is a certain statistical probability that helps the doctor determine the direction to look for the disease. In 40% of cases, why ESR increases, the reason lies in the development of infections. In 23% of cases, the development of benign or malignant tumors can be detected in the patient. Intoxication of the body or rheumatic diseases occur in 20% of cases. To identify a disease or syndrome affecting ESR, it is necessary to take into account all possible causes.

• Infectious processes (ARVI, influenza, pyelonephritis, cystitis, pneumonia, hepatitis, bronchitis, etc.) lead to the release of certain substances into the blood that affect cell membranes and blood quality.
• Purulent inflammation causes an increase in ESR, but is usually diagnosed without a blood test. Suppuration (abscess, furunculosis, etc.) is visible to the naked eye.
• Oncological diseases, often peripheral, but also other neoplasms can cause a high erythrocyte sedimentation reaction.
• Autoimmune diseases (arthritis, etc.) lead to changes in the blood plasma, as a result of which the blood loses some properties and becomes defective.
• Kidney and bladder diseases
• Intoxication due to food poisoning and intestinal infections accompanied by vomiting and diarrhea
• Blood diseases (anemia, etc.)
• Diseases in which tissue necrosis is observed (heart attack, tuberculosis, etc.) lead to high ESR some time after cell destruction.

Physiological reasons

There are a number of situations in which the ESR increases, but this is not a consequence of a disease or pathological condition. In this case, erythrocyte sedimentation above normal is not considered a deviation and does not require drug treatment. The attending physician can diagnose the physiological causes of high ESR if there is comprehensive information about the patient, his lifestyle and medications taken.

• Anemia
• Weight loss as a result of a strict diet
• Period of religious fasting
• Obesity, which increases blood cholesterol levels
• Hangover state
• Taking hormonal contraceptives or other medications that affect hormone levels
• Toxicosis during pregnancy
• Breast-feeding
• Blood for analysis was donated on a full stomach

False positive result

The structural features of the body and lifestyle are reflected in the results of medical research. The reasons for the increase in ESR can be caused by addiction to alcohol and smoking, as well as tasty but unhealthy food. The individual characteristics of each adult must be taken into account when interpreting laboratory readings.

• Allergic reactions and taking allergy medications.
• Increasing cholesterol levels can affect the growth of ESR.
• Individual reactions of the body. According to medical statistics, 5% of patients experience an increase in ESR, while there are no concomitant pathologies.
• Uncontrolled consumption of vitamin A or vitamin complex.
• Formation of immunity after vaccination. At the same time, an increase in the number of certain types of white blood cells may also be observed.
• Lack of iron or the body's inability to absorb iron leads to dysfunction of red blood cells.
• Unbalanced diet, consumption of fatty or fried foods shortly before the analysis.
• In women, ESR may be increased at the beginning of menstruation.

A false positive result is caused by relatively harmless causes of elevated ESR. Most of them are not dangerous diseases requiring immediate medical intervention. However, the doctor may recommend giving up some bad habits or prescribe a balanced therapeutic diet.

A high ESR may be the result of a laboratory error.

In this case, it is advisable to re-test your blood. Errors are possible in both public and private (paid) institutions. Improper storage of a patient's blood sample, changes in laboratory temperature, incorrect amount of reagent, and other factors can distort the actual erythrocyte sedimentation rate.

How to reduce ESR

Erythrocyte sedimentation reaction is not a disease, and therefore cannot be cured. The disease that caused the abnormal blood test is being treated. The ESR readings will not return to normal until the cycle of drug treatment ends or the bone fracture heals. If deviations in the analysis are insignificant and are not a consequence of the disease, in agreement with the attending physician, you can resort to traditional medicine recipes.

Beetroot broth or freshly squeezed beetroot juice can reduce ESR to normal level. Fresh citrus juices with the addition of natural flower honey are also used. Your doctor may recommend taking vitamin and mineral complexes to normalize your body’s functioning.

The reasons for high ESR in the blood can be different, including the indicator can rise even in healthy people. When interpreting the results of the analysis, it is important to take into account all possible factors that could influence the increase in ESR levels. Until the cause of the high erythrocyte sedimentation reaction is identified and the diagnosis is established, treatment is not prescribed.

In contact with

Every day, more and more new ways to diagnose diseases appear in the world of medicine. Despite this, a general blood test is still the most important. This is the first study that doctors refer to for any complaints. IN general analysis leukocytes, hemoglobin, platelets and other significant components are assessed. Along with them, one of the main indicators that helps assess the patient’s condition will be ESR.

What is ESR?

ESR - this term stands for capital letters the full name is “erythrocyte sedimentation rate”. Now let's take a closer look at what kind of indicator this is, what can it talk about?

ESR is very important. Any deviation from normal indicators will indicate the presence of a certain inflammatory focus in a person’s body. In order to correctly determine the ESR level, the test must be taken in the morning, on an empty stomach. Otherwise, the results may be unreliable.

ESR shows us the degree to which red blood cells are deposited over a certain period of time.

Analysis of ESR allows, in combination with other indicators, to assess the state of the body. It can also be used to track the dynamics of the disease and judge the correctness of the choice of a specific treatment.

This indicator is very sensitive; it usually reacts in the earliest stages of the disease, when there are no clinical symptoms. The level of ESR increases in infectious, rheumatological, and oncological diseases.

It happens that ESR can increase even under severe stress, physical fatigue, and dietary restrictions. But in this case, its increase is short-term.

Important! If the ESR level is high for a long time, you should be carefully examined to determine the cause.

How is ESR determined?

ESR in the blood is usually determined by two methods: according to Westergren and according to Panchenkov.

The technique by which analysis is most often performed is the Panchenkov method. Its essence is to mix capillary blood with sodium citrate (an anticoagulant), after which it will separate into two layers. The bottom layer will contain red blood cells, the top layer will contain plasma and white blood cells.

A number of factors can be identified that will influence the erythrocyte sedimentation rate:

• Red blood cell count. If their amount in the blood is reduced, then sedimentation will occur faster. Accordingly, if their content is increased, it means that they will settle more slowly.
• If you get an infection the immune system will respond by producing special antibodies, which causes the ESR to increase.
• With increased acidity of the blood, the ESR will also increase.

Currently, the vast majority of laboratories are equipped with special equipment for calculating ESR automatically. This is effective because it eliminates errors due to the human factor.

Normal ESR in the blood

ESR standards are variable and may depend on the patient’s age, gender, psychological state, weight, and individual characteristics.

• norm for men: 1-12 mm/h
• norm for women: 2-16 mm/h
• in pregnant women, ESR will always be elevated: up to 45 mm/h
• normal for children:
  • in the first days of life – 1 mm/h;
  • 0-6 months – 2-4 mm/h;
  • 6 months – 1 year – 4-9mm/h;
  • 1-10 years – 4-12 mm/h;
  • up to 18 years – 2-12 mm/h.

ESR: norm, reasons for increase (video)

After watching this video, you can get an idea of ​​what ESR is, get a little familiar with its norms and find out why it may be increased.

Reasons for decreased ESR

Low ESR values ​​do not always indicate health problems. The following reasons are identified:

• Cholecystitis, liver diseases. As a result of these diseases, an increased amount of bile is produced.
• Increased number of red blood cells.
• Heart failure.
• Increased blood acidity.
• Deficiency of vitamins and minerals. May be low for vegans, in this case it is considered as a variant of the norm.
• Sickle cell anemia. Red blood cells have an irregular shape and, accordingly, settle more slowly.

Very rarely, low ESR will accompany circulatory disorders, stomach ulcers, epilepsy, and the use of certain medications (aspirin).

Reasons for increasing ESR

There are many reasons why the erythrocyte sedimentation rate may increase. Let's start with the fact that there may be elementary physiological reasons for this.

These include:

• dietary restrictions, all kinds of diets and fasting;
• pregnancy;
• the presence of menstruation at the time of taking the analysis;
• allergies;
• the blood test was not taken on an empty stomach (you cannot eat 8 hours before donating blood);
• helminthiasis.

Increased ESR in the presence of diseases. There are several groups:

• Autoimmune diseases and collagenoses: systemic lupus erythematosus, vasculitis, rheumatism, scleroderma, dermatomyositis, periarteritis nodosa, rheumatoid polyarthritis, bronchial asthma, etc.
• Infectious diseases. Acute respiratory viral infections, bronchitis, sinusitis, pharyngitis, influenza, cystitis, pyelonephritis and others. All of these diseases cause a strong immune response and increased production of antibodies. A high concentration of immunoglobulins in the blood increases the ESR.
• Oncology.
• Pulmonary tuberculosis.
• Myocardial infarction. Damaged heart muscle initiates an inflammatory response, as a result of which fibrinogen is intensively synthesized, which leads to an increase in ESR.
• Endocrine diseases. Diabetes, hypothyroidism, hyperthyroidism.
• Kidney diseases - hydronephrosis, glomerulonephritis, urolithiasis.
• Conditions in which the viscosity of the blood increases. Severe food poisoning, intestinal obstruction, blood transfusion.
• Injuries, burns.
• Diseases associated with metabolic disorders. Cystic fibrosis, obesity.

It should be noted that the ESR does not increase instantly to high levels, but gradually, within a day or two after the onset of the disease. As you recover, the decrease in ESR also occurs gradually.

Increased ESR in the blood in women and men

In females, an increase in ESR may be due to:

• taking oral contraceptives;
• menstruation;
• period of pregnancy and breastfeeding;
• eating disorders. Women often abuse low-calorie diets.

All these reasons do not pose any danger; it is considered physiological.

In some men (about 5-8%), the ESR is slightly increased, this is also a variant of the norm. It may be a matter of lifestyle, abuse of bad habits, or simply personal characteristics.

Increased ESR in the blood of a child

High ESR in children is often due to the same reasons as in adults.

• infectious diseases;
• allergies;
• severe intoxication of the body;
• injuries;
• impaired metabolism;
• worms.

Note! If the ESR is slightly increased, the reason may be different: lack of vitamins, teething, taking medications.

To find out the cause, parents should take care of a thorough examination of the child.

How to reduce ESR

A high ESR in itself is not a pathology. It only indicates that there is some kind of disease in the body. Its normalization will occur when the disease is completely cured.

In most cases, elimination of the inflammatory process in the body is required. To determine an accurate diagnosis, additional research. After this, the doctor makes his verdict and prescribes proper treatment. After the disease is cured, the ESR decreases.

Poor blood tests are often associated with liver problems. She may suffer due to poor nutrition, alcohol, excess weight, infectious and viral diseases. As a result, the liver does not have time to perform the function of cleansing the body of toxins, and they enter the bloodstream. As a result, the ESR may deviate from normal values. Then treatment measures should be aimed at eliminating this problem. You can have a drink medications to support liver function, liver herbal preparations.

Laboratory analysis for determining ESR in the blood is a nonspecific test for inflammatory processes in the body. The test is highly sensitive, but it cannot be used to determine the cause of an increase in erythrocyte sedimentation rate (ESR) in a blood test.

ESR, definition

Erythrocyte sedimentation rate serves as an indicator of general clinical analysis. By determining the rate at which red blood cell deposition occurs, one can evaluate over time how effective the treatment is and how quickly recovery occurs.

Methods of analysis for elevated ESR have been known since the beginning of the last century, as a study to determine ROE, which means “erythrocyte sedimentation reaction”; such a blood test is mistakenly called soy.

Analysis for determining ROE

An analysis to determine the rate at which red blood cells are deposited is carried out in morning hours. At this time, ROE is higher than in the afternoon or evening. The test is taken on an empty stomach after 8-14 hours of fasting. To conduct the study, material is taken from a vein or taken after a finger prick. An anticoagulant is added to the sample to prevent clotting.

Then place the test tube with the sample vertically and incubate for an hour. During this time, the separation of plasma and red blood cells occurs. Red blood cells settle to the bottom of the test tube under the influence of gravity, and a column of transparent plasma remains above them.

The height of the liquid column above the settled erythrocytes shows the value of the erythrocyte sedimentation rate. The unit of measurement of ESR is mm/hour. The erythrocytes that sink to the bottom of the tube form a blood clot.

An increased ESR means that the test results exceed the norm, and this is caused by a high content of proteins that promote the adhesion of red blood cells in the blood plasma.

A high level of ESR can be caused by reasons related to changes in the composition of proteins in the blood plasma:

• reduced level of albumin protein, which normally prevents the adhesion (aggregation) of red blood cells;
• increased plasma concentrations of immunoglobulins and fibrinogen, which enhance erythrocyte aggregation;
• decreased erythrocyte density;
• changes in plasma pH;
• poor nutrition – deficiency of minerals and vitamins.

A high ESR in the blood has no independent significance, but such a study is used in combination with other diagnostic methods, and this means that one cannot draw a conclusion about the nature of the patient’s disease based on analysis alone.

If ESR levels in the blood increase after diagnosis, this means that it is necessary to change the treatment regimen and conduct additional tests to establish the real reason why soy remains high.

Normal level of ROE values

The range of values ​​that are considered normal is determined statistically when examining healthy people. The average ROE value is taken as the norm. This means that some healthy adults will have elevated ESR in their blood.

The normal blood level depends on:

• by age:
  • older people have higher levels of soy compared to young men and women;
  • children have lower ESR than adults;
• by gender - this means that women have higher ROE indicators than men.

The disease cannot be diagnosed by exceeding the normal ESR level in the blood. Elevated values ​​can be found in completely healthy people, while there are cases of normal test values ​​in cancer patients.

The cause of increased ROE may be an increase in the concentration of cholesterol in the blood, taking oral contraceptives, anemia, or pregnancy. The presence of bile salts, increased plasma viscosity, and the use of analgesics can reduce the analysis parameters.

ESR norm (measured in mm/hour):

• in children;
  • age 1-7 days – from 2 to 6;
  • 12 months – from 5 to 10;
  • 6 years – from 4 to 12;
  • 12 years – from 4 – 12;
• adults;
  • in men;
    • up to 50 years old from 6 to 12;
    • men after 50 years - from 15 to 20;
  • among women;
    • up to 30 years – from 8 to 15;
    • women from 30 to 50 years –8 – 20;
    • in women, starting from the age of 50 - 15-20;
    • for pregnant women - from 20 to 45.

Increased ESR in women during pregnancy is observed from 10-11 weeks, and can remain at a high level in the blood for another month after birth.

If a woman has a high ESR in her blood for longer than 2 months after childbirth, and the increase reaches 30 mm/h, this means that inflammation is developing in the body.

There are 4 degrees of increase in the level of ESR in the blood:

• the first degree corresponds to the norm;
• the second degree falls in the range from 15 to 30 mm/h - this means that soybean is moderately increased, the changes are reversible;
• the third degree of increased ESR - soybean analysis is higher than normal (from 30 mm/h to 60), this means that there is strong aggregation of erythrocytes, a lot of gamma globulins have appeared, and the amount of fibrinogen has increased;
• the fourth degree corresponds to high level ESR, test results exceed 60 mm/h, which means a dangerous deviation of all indicators.

Diseases with elevated ESR

ESR in an adult may be elevated in the blood for the following reasons:

• acute and chronic infections;
• autoimmune diseases;
• systemic pathologies of connective tissues;
  • vasculitis;
  • arthritis;
  • systemic lupus erythematosus - SLE;
• malignant tumors:
  • hemoblastoses;
  • collagenosis;
  • multiple myeloma;
  • Hodgkin's disease;
• tissue necrosis;
• amyloidosis;
• heart attack;
• stroke;
• obesity;
• stress;
• purulent diseases;
• diarrhea;
• burn;
• liver diseases;
• nephrotic syndrome;
• jade;
• large blood loss;
• intestinal obstruction;
• operations;
• injuries;
• chronic hepatitis;
• high cholesterol.

Accelerates the reaction of erythrocyte sedimentation food intake, the use of aspirin, vitamin A, morphine, dextrans, theophylline, methyldopa. In women, the cause of an increase in ESR in the blood can be menstruation.

It is advisable for women of reproductive age to conduct a soy blood test 5 days after last day monthly so that the results do not exceed the norm.

In adults under 30 years old, if the ESR in blood tests is increased to 20 mm / h, this condition means that there is a focus of inflammation in the body. For older people, this value is within the normal range.

Diseases occurring with a decrease in ESR

A decrease in the rate of sedimentation of red blood cells is observed in diseases:

• cirrhosis of the liver;
• heart failure;
• erythrocytosis;
• sickle anemia;
• spherocytosis;
• polycythemia;
• obstructive jaundice;
• hypofibrinogenemia.

Slows down the rate of sedimentation in the treatment of calcium chloride, corticosteroids, diuretics, glucose. The use of corticosteroids, treatment with albumin can reduce the activity of the erythrocyte sedimentation reaction.

ROE values ​​in diseases

The greatest rise in analysis values ​​occurs in inflammatory and oncological processes. An increase in the values ​​of analyzes for ESR is noted 2 days after the onset of inflammation, which means that inflammatory proteins appeared in the blood plasma - fibrinogen, complement proteins, immunoglobulins.

The cause of a very high ROE in the blood is not always fatal dangerous disease. For symptoms of inflammation of the ovaries, fallopian tubes in women, signs of purulent sinusitis, otitis and other purulent infectious diseases ESR tests in the blood can reach 40 mm/h - an indicator that is not usually expected in these diseases.

In acute purulent infections, the indicator can reach 100 mm/hour, but this does not mean that the person is terminally ill. This means that you need to undergo treatment and do the test again after 3 weeks (the lifespan of red blood cells), and sound the alarm if there is no positive dynamics and soya in the blood is still elevated.

The reasons why there is a sharply increased level of soya in the blood, reaching up to 100 mm/h, are:

• pneumonia;
• flu;
• bronchitis;
• hepatitis;
• fungal, viral infections.

SLE, arthritis, tuberculosis, pyelonephritis, cystitis, myocardial infarction, angina pectoris, ectopic pregnancy - with all these and a number of other diseases in adults, the ESR indicator in blood tests is increased, which means that the body is actively producing antibodies and inflammatory factors.

In children, the ESR rate is sharply increased during acute roundworm infection; the amount of immunoglobulins in the blood increases, which means that the risk increases allergic reactions. ROE for helminthiasis in children can reach 20-40 mm/h.

Soybeans rise to 30 and above when ulcerative colitis. Anemia is another reason why a woman has elevated soybean levels in her blood; its value increases to 30 mm/hour. Increased soya in the blood in women with anemia is a very unfavorable symptom, which means low hemoglobin in combination with the inflammatory process, and occurs in pregnant women.

In a woman of reproductive age, the cause of an elevated ESR in the blood, reaching 45 mm/h, may be endometriosis.

Endometrial growth increases the risk of infertility. That is why, if a woman has an increased ESR in her blood, and it increases with repeated tests, she definitely needs to be examined by a gynecologist to rule out this disease.

Spicy inflammatory process with tuberculosis, it raises ROE values ​​to 60 and above. Koch's bacillus, which causes this disease, is not sensitive to most anti-inflammatory drugs and antibiotics.

Changes in autoimmune diseases

ROE rises significantly with autoimmune diseases chronic, with frequent relapses. By repeating the analysis, you can get an idea of ​​whether the disease is in the acute stage and determine how correctly the treatment regimen has been chosen.

At rheumatoid arthritis ROE values ​​increase to 25 mm/h, and during exacerbations they exceed 40 mm/h. If a woman has an increased ESR, reaching 40 mm/h, this means that the amount of immunoglobulins in the blood is increased, and one of possible reasons This condition is thyroiditis. This disease is often autoimmune in nature and occurs 10 times less often in men.

With SLE, test values ​​increase to 45 mm/h and even more, and can reach 70 mm/h; the level of increase often does not correspond to the danger of the patient’s condition. A sharp increase in test results means the addition of an acute infection.

In kidney diseases, the range of ROE values ​​is very wide, the indicators vary depending on gender, the degree of the disease from 15 to 80 mm/h, always exceeding the norm.

Indicators for oncology

High ESR in adults with cancer is more often observed due to a solitary (single) tumor; blood test values ​​reach values ​​of 70-80 mm/h or more.

A high level is observed in malignant neoplasms:

• bone marrow;
• intestines;
• lungs;
• ovary;
• mammary glands;
• cervix;
• lymph nodes

Such high rates are also observed in other diseases, mainly in acute infections. If the patient does not experience a decrease in test results when taking anti-inflammatory drugs, the doctor may refer the patient for additional examination to rule out cancer.

It is not always with oncology that the ESR in the blood rises sharply and its value is much higher than normal, which does not allow the use of such a study as a diagnostic one. There are enough cases known when cancer occurs with ROE less than 20 mm/h.

However, this analysis can help in diagnosis already in the early stages of the disease, since an increase in analysis indicators is noted in the early stages of cancer, when there are often no clinical symptoms of the disease.

With an increase in ESR in the blood, there is no single treatment regimen, since the reasons for the increase are varied. It is possible to influence the test results only if the treatment of the disease that caused the increase in ESR is started.