The rate of ESR and its change in pathology
As a result of the fact that the actual ESR is considerednonspecific reaction and varies with a variety of conditions, its differential diagnostic value is relatively small. But, nevertheless, this is one of the most important indicators of a general blood test.
Being in the blood, red blood cells carrying a negativecharge, mutually repel, this, in fact, prevents them from sticking together. Outside the blood vessels in the blood, protected from clotting by any anticoagulant and recruited into a vertically standing vessel, the erythrocytes begin to settle under the influence of gravity, and then they agglomerate - merging into associations that settle even faster. This process is promoted by the protein components of the plasma and mucopolysaccharides. Therefore, the factors that lead to an increase in their content in the blood lead to an acceleration of erythrocyte sedimentation. Acceleration is determined with the main number of inflammatory diseases, infections, malignant neoplasms, connective tissue diseases, nephroses, tissue decay. For some diseases, there is typically no increase in erythrocyte sedimentation in the initial period (epidemic hepatitis, typhoid fever), its slowdown occurs with heart failure.
ESR in the blood - the norm
The rate of ESR depends on many factors to whichinclude age, sex, physiological state of the body. In men, the values of this index are allowed from 4 to 10 mm / h. ESR rate in women is higher and ranges from 4 to 15 mm / hour. In childhood, the rate of erythrocyte sedimentation gradually increases to adult indices. The rate of ESR in newborns is only 1 mm / hour.
The rate of erythrocyte sedimentation may beincreased and decreased. The increase occurs with a sudden change in the dietary regime with a rise in the menu of protein foods and in the fairer sex during pregnancy. The rate of ESR during pregnancy can reach 45 mm / h.
The most intensive increase, reachingvalues above 30 mm / h, is observed in purulent processes, collagenoses, malignant neoplasms, such as hemoblastosis, severe anemia, sometimes with uremia and thyrotoxicosis with the development of thyrotoxic crises.
A slight increase with values of about 15-25mm / hour is most often observed in acute inflammatory processes, with the hidden, low-symptomatic flow of a variety of chronic infections. The list of diseases in which an increase in ESR can be observed is so great that it actually lowers the diagnostic significance of this indicator of a general blood test.
Reduction in the rate of erythrocyte sedimentation to values below 5-6 mm / h occurs when:
- mechanical and parenchymal jaundice due to an increase in the content of bile acids in the blood;
- reduction of the amount of total protein in the blood in case of severe alimentary dystrophy;
- severe illness accompanied by exhaustion;
- severe stage of cardiovascular and respiratory failure due to hypercapnia and acidosis;
- sudden increase in the content of red blood cells and hemoglobin in the blood with erythremia and symptomatic erythrocytosis;
- long use of medicines: Acetylsalicylic acid, phenobarbital, diuretics, calcium substances and other medications. The slowdown of this indicator, in addition, is in the agonal state.
Sedation of erythrocytes occasionally appearsan independent diagnostic feature, although it always makes it possible to conclude about the degree of activity of the pathological process. Of particular importance to him attached to tuberculosis, rheumatism and other collagenoses. The rate of erythrocyte sedimentation sometimes varies in proportion to other signs of activity. So, for example, it lags in comparison with leukocytosis and an increase in temperature with appendicitis or myocardial infarction and normalizes them more slowly.
The rate of ESR does not exclude a disease in which it is usually accelerated, along with this, there is no acceleration of ESR in practically healthy people.