ESR in the blood (erythrocyte sedimentation rate) is a measure of the speed at which blood is separated 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 formed plasma layer in millimeters in one hour is estimated. The specific gravity of erythrocytes is higher than that of plasma; therefore, 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 (sedimentation), experts are divided into three phases, occurring at different speeds. At first, a slow drop in red blood cells to the bottom of individual cells is observed. In the next stage, “coin columns” (aggregates) are formed, and ESR in the blood increases. The last phase is characterized by the formation of a large number of red blood cell aggregates. Their fall slows down and then stops.
The ESR in the blood can change under the influence of various pathological and physiological factors. In women, as medical practice shows, the values are slightly higher than men's indicators.
During pregnancy, an increase in ESR in the blood is due to a change in the protein composition of red blood cells. A decrease in their concentration (anemia) helps to accelerate sedimentation, an increase in their content, on the contrary, slows down the process. During the day, fluctuations in indicators are likely. The highest level is characteristic of daytime.
Protein composition in blood plasma is the main factor influencing the formation of “coin columns”. Under the influence of acute phase proteins, a decrease in the charge of red blood cells and their repulsion from each other occurs. Thus, the formation of "coin columns" 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, in acute inflammation and infections, a change in sedimentation rate is observed 24 hours after an increase in the concentration of leukocytes and an increase in temperature. Against the background of chronic inflammation, the acceleration of sedimentation is caused by a large number of immunoglobulins and fibrinogen.
Measurement of ESR is considered as a screening test that does not have specificity for any particular pathology. This type of study, as a rule, is used in the complex KLA (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.
An increase in the ESR indicator of a physiological nature is noted in old age, in pregnant women, after childbirth, and also during menstruation.
Pathological acceleration of sedimentation is detected with intoxication, inflammation, chronic and acute infections (tuberculosis, osteomyelitis, syphilis, pneumonia). Increased rates are also observed with myocardial infarction, autoimmune diseases, fractures, bone injuries, after operations, in a state of shock, with anemia, as well as when taking certain medications. Accelerated sedimentation may indicate kidney disease, hyperfibrinogenemia. An elevated ESR is detected in oncology. However, according to many experts, the indicator is not directly associated with a malignant neoplasm.
ESR slowdown is noted with a decrease in muscle mass, starvation, while taking corticosteroids, in the first and second trimesters of pregnancy, with myodystrophy, hyperhydration, as well as with a vegetarian diet.