What will happen with the wrong ratio of soy. The erythrocyte sedimentation rate is increased - what does this mean and how dangerous is it. Interpretation of results and possible causes

[02-007 ] Erythrocyte sedimentation rate (ESR)

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A test that evaluates the rate at which blood separates into plasma and red blood cells. The rate of separation is mainly determined by the degree of their aggregation, i.e., the ability to stick together with each other.

Russian synonyms

Erythrocyte sedimentation reaction, ROE, ESR.

SynonymsEnglish

Erythrocyte sedimentation rate, Sed rate, Sedimentation rate, Westergren sedimentation rate.

Research method

Method of capillary photometry.

Units

mm/h (millimeter per hour).

What biomaterial can be used for research?

Venous, capillary blood.

How to properly prepare for research?

Eliminate alcohol from the diet for 24 hours prior to the study.
Do not eat for 2-3 hours before the study (you can drink clean non-carbonated water).
Stop taking medications 24 hours before the study (as agreed with the doctor).
Eliminate physical and emotional overstrain for 30 minutes before the study.
Do not smoke for 30 minutes prior to the study.

General information about the study

Determination of the erythrocyte sedimentation rate (ESR) is an indirect method for detecting an inflammatory, autoimmune, or oncological disease. It is performed on a sample of venous or capillary blood, which has been added to a substance that allows it not to clot (anticoagulant). When analyzing ESR by the Panchenkov method, blood is placed in a thin glass or plastic test tube and monitored for an hour. At this time, erythrocytes (red blood cells), as having a large specific gravity, settle, leaving a column of transparent plasma above them. According to the distance from the upper border of the plasma to the erythrocytes, the ESR is calculated. Normally, red blood cells settle slowly, leaving very little pure plasma. For this method, a Panchenkov apparatus is used, consisting of a stand and capillary pipettes with a scale of 100 mm.

In capillary photometry (automatic analyzers ROLLER, TEST1) the kinetic method of "stopped jet" is used. At the beginning of the ESR analysis, a programmed mixing of the sample takes place in order to disaggregate the erythrocytes. Ineffective disaggregation or the presence of microclots can affect the final result, since the analyzer actually measures the kinetics of erythrocyte aggregation. In this case, the measurement takes place in the range from 2 to 120 mm / h. The results of measuring ESR by this method have a high correlation with the Westergren method, which is the reference for determining ESR in the blood, and the same reference values.

The results obtained when using the method of capillary photometry, in the region of normal values, coincide with the results obtained when determining the ESR by the Panchenkov method. However, the capillary photometry method is more sensitive to an increase in ESR, and the results in the zone of elevated values are higher than the results obtained by the Panchenkov method.

An increase in the level of pathological proteins in the liquid part of the blood, as well as some other proteins (the so-called acute-phase proteins that appear during inflammation) contributes to the "gluing" of red blood cells. Because of this, they settle faster and the ESR rises. It turns out that any acute or chronic inflammation can lead to an increase in ESR in the blood.

The fewer red blood cells, the faster they settle, so women have a higher ESR than men. The norm of ESR is different depending on gender and age.

What is research used for?

To diagnose diseases associated with acute or chronic inflammation, including infections, cancers, and autoimmune diseases. The determination of ESR is sensitive, but one of the least specific laboratory tests, since an increase in ESR in the blood alone does not allow determining the source of inflammation, in addition, it can occur not only due to inflammation. That is why the ESR analysis is usually used in combination with other studies.

When is the study scheduled?

During diagnostics and monitoring:
- inflammatory diseases,
- infectious diseases,
- oncological diseases,
- autoimmune diseases.
When conducting preventive examinations in conjunction with other studies (general blood count, leukocyte formula, etc.).

What do the results mean?

Reference values (ESR norm - table)

The results of this analysis must be interpreted in the light of clinical findings, medical history, and other analyses.

Causes of increased ESR in the blood

Infectious diseases (usually bacterial causes). ESR can increase in both acute and chronic infectious diseases.
Inflammatory diseases.
Connective tissue diseases (rheumatoid arthritis, systemic lupus erythematosus, systemic scleroderma, vasculitis).
Inflammatory bowel disease (Crohn's disease, ulcerative colitis).

Oncological diseases:
1. Myeloma. As a rule, it is accompanied by a very high level of ESR in the blood, because with it pathological proteins are synthesized in large quantities, which cause the formation of erythrocyte "coin columns".
2. Hodgkin's disease is a malignant disease of the lymph nodes. The ESR indicator is usually used not to make a diagnosis, but to monitor the course and effectiveness of treatment of an already diagnosed disease.
3. Cancer of various localizations, especially hemoblastoses. It is believed that an extremely high level of ESR in the blood indicates the spread of the tumor beyond the primary focus (i.e., metastases).

Myocardial infarction. With it, damage to the heart muscle occurs, which causes a systemic inflammatory response and, accordingly, an increase in ESR. After a heart attack, ESR peaks about a week later.
Anemia. A decrease in the number of erythrocytes can lead to an increase in their sedimentation rate.
Burns, injuries.
Amyloidosis is a disease associated with the accumulation of an abnormal protein in the tissues.

Causes of a decrease in ESR in the blood

Diseases that are accompanied by a change in the shape of red blood cells, such as sickle cell anemia or hereditary spherocytosis (these make it difficult for red blood cells to settle).
Polycythemia (an increase in the number of red blood cells) and conditions that lead to it, such as, for example, chronic heart failure or lung disease.

What can influence the result? Leukocyte formula

Who orders the study?

Therapist, oncologist, hematologist, infectious disease specialist.

Complete blood count (CBC).

This is the most common blood test, which includes determining the concentration of hemoglobin, the number of erythrocytes, leukocytes and platelets per unit volume, hematocrit and erythrocyte indices (MCV, MCH, MCHC).

screening and dispensary examinations;
monitoring of ongoing therapy;
differential diagnosis of blood diseases.

What is hemoglobin (Hb, Hemoglobin)?

Hemoglobin is the respiratory pigment of the blood, which is contained in red blood cells and is involved in the transport of oxygen and carbon dioxide, the regulation of the acid-base state.

Hemoglobin consists of two parts: protein and iron. In men, the hemoglobin content is slightly higher than in women. Children under one year old have a physiological decrease in hemoglobin. Physiological forms of hemoglobin:

oxyhemoglobin (HbO2) - the combination of hemoglobin with oxygen - is formed mainly in arterial blood and gives it a scarlet color;
reduced hemoglobin or deoxyhemoglobin (HbH) - hemoglobin that has given oxygen to tissues;
carboxyhemoglobin (HbCO2) - a compound of hemoglobin with carbon dioxide - is formed mainly in venous blood, which, as a result, acquires a dark cherry color.

When can hemoglobin concentration increase?

For diseases and conditions:

leading to thickening of the blood (burns, persistent vomiting, intestinal obstruction, dehydration or prolonged dehydration);

accompanied by an increase in the number of erythrocytes - primary and secondary erythrocytosis (mountain sickness, chronic obstructive pulmonary disease, damage to the blood vessels of the lungs, persistent tobacco smoking, hereditary hemoglobinopathies with an increased affinity of hemoglobin to oxygen and a deficiency of 2,3-diphosphoglycerate in erythrocytes, congenital "blue" defects heart, polycystic kidney disease, hydronephrosis, stenosis of the renal arteries as a result of local ischemia of the kidneys, adenocarcinoma of the kidneys, hemangioblastoma of the cerebellum, Hippel-Lindau syndrome, hematoma, uterine myoma, atrial myxoma, tumor diseases of the endocrine glands, etc.);

physiological conditions (in residents of high mountains, pilots, climbers, after increased physical activity, prolonged stress).

When can hemoglobin concentration decrease?

With anemia of various etiologies (posthemorrhagic acute with acute blood loss; iron deficiency with chronic blood loss, after resection or with severe damage to the small intestine; hereditary, associated with impaired synthesis of porphyrins; hemolytic anemia associated with increased destruction of red blood cells; aplastic anemia associated with the toxic effects of certain medications, chemicals, idiopathic, the causes of which are unclear; megaloblastic anemia associated with a deficiency of vitamin B12 and folic acid; anemia due to lead poisoning).

With hyperhydration (an increase in the volume of circulating plasma due to detoxification therapy, the elimination of edema, etc.).

What is an erythrocyte (Red Blood Cells, RBC)?

Erythrocytes are highly specialized non-nuclear blood cells that have the shape of biconcave discs. Due to this shape, the surface of the red blood cells is larger than if it had the shape of a ball. Such a special form of erythrocytes contributes to their main function - the transfer of oxygen from the lungs to tissues and carbon dioxide from tissues to the lungs, and also due to this form, erythrocytes have a greater ability to reversibly deform when passing through narrow curved capillaries. RBCs are formed from reticulocytes after they leave the bone marrow. About 1% of red blood cells are renewed in one day. The average life span of erythrocytes is 120 days.

When can red blood cell levels increase (erythrocytosis)?

Erythremia, or Wakez's disease, is one of the variants of chronic leukemia (primary erythrocytosis).

Secondary erythrocytosis:

absolute - caused by hypoxic conditions (chronic lung diseases, congenital heart defects, increased physical activity, staying at high altitudes); associated with increased production of erythropoietin, which stimulates erythropoiesis (renal parenchyma cancer, hydronephrosis and polycystic kidney disease, liver parenchyma cancer, benign familial erythrocytosis); associated with an excess of adrenocorticosteroids or androgens (pheochromocytoma, Itsenko-Cushing's disease / syndrome, hyperaldosteronism, cerebellar hemangioblastoma);

relative - with thickening of the blood, when the plasma volume decreases while maintaining the number of red blood cells (dehydration, excessive sweating, vomiting, diarrhea, burns, increasing swelling and ascites; emotional stress; alcoholism; smoking; systemic hypertension).

When can red blood cell levels decrease (erythrocytopenia)?

With anemia of various etiologies: as a result of a deficiency of iron, protein, vitamins, aplastic processes, hemolysis, hemoblastosis, metastasis of malignant neoplasms.

What are erythrocyte indices (MCV, MCH, MCHC)?

Indices that allow you to quantify the main morphological characteristics of erythrocytes.

MCV - Mean Cell Volume.

This is a more accurate parameter than a visual assessment of the size of red blood cells. However, it is not reliable in the presence of a large number of abnormal erythrocytes (for example, sickle cells) in the examined blood.

Based on the MCV value, anemia is distinguished:

microcytic MCVs< 80 fl (железодефицитные анемии, талассемии, сидеробластные анемии);
normocytic MCV from 80 to 100 fl (hemolytic anemia, anemia after blood loss,
hemoglobinopathies);
macrocytic MCV > 100 fl (B12 and folate deficiency anemia).

MCH - the average content of hemoglobin in an erythrocyte (Mean Cell Hemoglobin).

This indicator determines the average content of hemoglobin in a single erythrocyte. It is similar to the color index, but more accurately reflects the synthesis of Hb and its level in the erythrocyte. Based on this index, anemia can be divided into normo-, hypo- and hyperchromic:

normochromia is typical for healthy people, but can also occur with hemolytic and aplastic anemia, as well as anemia associated with acute blood loss;
hypochromia is due to a decrease in the volume of red blood cells (microcytosis) or a decrease in the level of hemoglobin in a red blood cell of normal volume. This means that hypochromia can be combined with both a decrease in the volume of erythrocytes, and be observed with normo- and macrocytosis. It occurs with iron deficiency anemia, anemia in chronic diseases, thalassemia, with some hemoglobinopathies, lead poisoning, impaired synthesis of porphyrins;
hyperchromia does not depend on the degree of saturation of erythrocytes, hemoglobin, but is due only to the volume of red blood cells. It is observed in megaloblastic, many chronic hemolytic anemias, hypoplastic anemia after acute blood loss, hypothyroidism, liver diseases, when taking cytostatics, contraceptives, anticonvulsants.

MCHC (Mean Cell Hemoglobin Concentration).

The average concentration of hemoglobin in an erythrocyte reflects the saturation of an erythrocyte with hemoglobin and characterizes the ratio of the amount of hemoglobin to the volume of the cell. Thus, unlike MSI, does not depend on the volume of the erythrocyte.

An increase in MCHC is observed in hyperchromic anemias (congenital spherocytosis and other spherocytic anemias).

A decrease in MCHC can be with iron deficiency, sideroblastic anemia, thalassemia.

What is hematocrit (Ht, hematocrit)?

This is the volume fraction of erythrocytes in whole blood (the ratio of the volumes of erythrocytes and plasma), which depends on the number and volume of erythrocytes.

The hematocrit value is widely used to assess the severity of anemia, in which it can decrease to 25-15%. But this indicator cannot be assessed soon after the loss of blood or blood transfusion, because. you can get falsely high or false low results.

Hematocrit may decrease slightly when taking blood in the supine position and increase with prolonged compression of the vein with a tourniquet during blood sampling.

When can hematocrit increase?

Erythremia (primary erythrocytosis).

Secondary erythrocytosis (congenital heart disease, respiratory failure, hemoglobinopathies, kidney neoplasms, accompanied by increased production of erythropoietin, polycystic kidney disease).

Reducing the volume of circulating plasma (blood thickening) with burn disease, peritonitis, dehydration of the body (severe diarrhea, uncontrollable vomiting, excessive sweating, diabetes).

When can the hematocrit decrease?

anemia.
Increase in circulating blood volume (second half of pregnancy, hyperproteinemia).
Hyperhydration.

What is a leukocyte (White Blood Cells, WBC)?

Leukocytes, or white blood cells, are colorless cells of various sizes (from 6 to 20 microns), round or irregular in shape. These cells have a nucleus and are able to move independently like a single-celled organism - an amoeba. The number of these cells in the blood is much less than erythrocytes. Leukocytes are the main protective factor in the fight of the human body against various diseases. These cells are "armed" with special enzymes that are able to "digest" microorganisms, bind and break down foreign protein substances and decay products that are formed in the body during life. In addition, some forms of leukocytes produce antibodies - protein particles that infect any foreign microorganisms that enter the bloodstream, mucous membranes and other organs and tissues of the human body. The formation of leukocytes (leukopoiesis) takes place in the bone marrow and lymph nodes.

There are 5 types of leukocytes:

neutrophils,
lymphocytes,
monocytes,
eosinophils,
basophils.

When can the number of white blood cells rise (leukocytosis)?

Acute infections, especially if their causative agents are cocci (staphylococcus, streptococcus, pneumococcus, gonococcus). Although a number of acute infections (typhoid, paratyphoid, salmonellosis, etc.) can in some cases lead to leukopenia (a decrease in the number of leukocytes).
Suppuration and inflammatory processes of various localization: pleura (pleurisy, empyema), abdominal cavity (pancreatitis, appendicitis, peritonitis), subcutaneous tissue (panaritium, abscess, phlegmon), etc.
Rheumatic attack.
Intoxications, including endogenous (diabetic acidosis, eclampsia, uremia, gout).
Malignant neoplasms.
Trauma, burns.
Acute bleeding (especially if the bleeding is internal: into the abdominal cavity, pleural space, joint, or in the immediate vicinity of the dura mater).
Operational interventions.
Heart attacks of internal organs (myocardium, lungs, kidneys, spleen).
Myelo- and lymphocytic leukemia.
The result of the action of adrenaline and steroid hormones.
Reactive (physiological) leukocytosis: exposure to physiological factors (pain, cold or hot bath, physical activity, emotional stress, exposure to sunlight and UV rays); menstruation; the period of childbirth.

When can the white blood cell count go low (leukopenia)?

Some viral and bacterial infections (influenza, typhoid fever, tularemia, measles, malaria, rubella, mumps, infectious mononucleosis, miliary tuberculosis, AIDS).
Sepsis.
Hypo- and aplasia of the bone marrow.
Damage to the bone marrow by chemicals, drugs.
Exposure to ionizing radiation.
Splenomegaly, hypersplenism, condition after splenectomy.
Acute leukemia.
Myelofibrosis.
myelodysplastic syndromes.
Plasmacytoma.
Metastases of neoplasms in the bone marrow.
Addison-Birmer disease.
Anaphylactic shock.
Systemic lupus erythematosus, rheumatoid arthritis and other collagenoses.
Reception of sulfonamides, chloramphenicol, analgesics, non-steroidal. anti-inflammatory drugs, thyreostatics, cytostatics.

What is a platelet (Platelet count, PLT)?

Platelets, or platelets, are the smallest among the cellular elements of the blood, the size of which is 1.5-2.5 microns. Platelets perform angiotrophic, adhesive-aggregative functions, participate in the processes of coagulation and fibrinolysis, and provide retraction of the blood clot. They are able to carry on their membrane circulating immune complexes, coagulation factors (fibrinogen), anticoagulants, biologically active substances (serotonin), and also maintain vasospasm. Platelet granules contain blood coagulation factors, peroxidase enzyme, serotonin, calcium ions Ca2+, ADP (adenosine diphosphate), von Willebrand factor, platelet fibrinogen, platelet growth factor.

When does the platelet count increase (thrombocytosis)?

Primary (as a result of proliferation of megakaryocytes):

essential thrombocythemia;
erythremia;
myeloid leukemia.

Secondary (occurring against the background of any disease):

inflammatory processes (systemic inflammatory diseases, osteomyelitis, tuberculosis);
malignant neoplasms of the stomach, kidneys (hypernephroma), lymphogranulomatosis;
leukemias (megacaricytic leukemia, polycythemia, chronic myeloid leukemia, etc.). In leukemia, thrombocytopenia is an early sign, and with the progression of the disease, thrombocytopenia develops;
cirrhosis of the liver;
condition after massive (more than 0.5 l) blood loss (including after major surgical operations), hemolysis;
condition after removal of the spleen (thrombocytosis usually persists for 2 months after surgery);
with sepsis, when the platelet count can reach 1000 * 109 / l .;
physical exercise.

When does the platelet count decrease (thrombocytopenia)?

Thrombocytopenia is always an alarming symptom, as it creates a threat of increased bleeding and increases the duration of bleeding.

Congenital thrombocytopenia:

Wiskott-Aldrich syndrome;
Chediak-Higashi syndrome;
Fanconi syndrome;
May-Hegglin anomaly;
Bernard-Soulier syndrome (giant platelets).

Acquired thrombocytopenia:

autoimmune (idiopathic) thrombocytopenic purpura (a decrease in the number of platelets due to their increased destruction under the influence of special antibodies, the mechanism of formation of which has not yet been established);
medicinal (when taking a number of medications, it causes toxic or immune damage to the bone marrow: cytostatics (vinblastine, vincristine, mercaptopurine, etc.); chloramphenicol; sulfanilamide preparations (biseptol, sulfodimethoxine), aspirin, butadione, reopyrin, analgin, etc.;
with systemic connective tissue diseases: systemic lupus erythematosus, scleroderma, dermatomyositis;
with viral and bacterial infections (measles, rubella, chicken pox, influenza, rickettsiosis, malaria, toxoplasmosis);
conditions associated with increased activity of the spleen in cirrhosis of the liver, chronic and less often acute viral hepatitis;
aplastic anemia and myelophthisis (replacing the bone marrow with tumor cells or fibrous tissue);
megaloblastic anemia, tumor metastases in the bone marrow; autoimmune hemolytic anemia and thrombocytopenia (Evans syndrome); acute and chronic leukemia;
dysfunction of the thyroid gland (thyrotoxicosis, hypothyroidism);
disseminated intravascular coagulation syndrome (DIC);
paroxysmal nocturnal hemoglobinuria (Marchiafava-Mikeli disease);
massive blood transfusions, extracorporeal circulation;
in the neonatal period (prematurity, hemolytic disease of the newborn, neonatal autoimmune thrombocytopenic purpura);
congestive heart failure, hepatic vein thrombosis;
during menstruation (by 25-50%).

What is the Erythrocyte Sedimentation Rate (ESR)?

This is an indicator of the rate of separation of blood in a test tube with added anticoagulant into 2 layers: upper (transparent plasma) and lower (settled erythrocytes). The erythrocyte sedimentation rate is estimated by the height of the formed plasma layer in mm for 1 hour. The specific gravity of erythrocytes is higher than the specific gravity of plasma, therefore, in a test tube, in the presence of an anticoagulant, erythrocytes settle to the bottom under the action of gravity. The rate at which erythrocyte sedimentation occurs is mainly determined by the degree of their aggregation, i.e., their ability to stick together. The aggregation of erythrocytes mainly depends on their electrical properties and the protein composition of blood plasma. Normally, red blood cells carry a negative charge (zeta potential) and repel each other. The degree of aggregation (and hence the ESR) increases with an increase in the plasma concentration of the so-called acute phase proteins - markers of the inflammatory process. First of all - fibrinogen, C-reactive protein, ceruloplasmin, immunoglobulins and others. On the contrary, ESR decreases with increasing albumin concentration. Other factors also affect the zeta potential of erythrocytes: plasma pH (acidosis reduces ESR, alkalosis increases), plasma ion charge, lipids, blood viscosity, the presence of anti-erythrocyte antibodies. The number, shape, and size of red blood cells also affect sedimentation. A decrease in the content of erythrocytes (anemia) in the blood leads to an acceleration of ESR and, on the contrary, an increase in the content of erythrocytes in the blood slows down the rate of sedimentation (sedimentation).

In acute inflammatory and infectious processes, a change in the erythrocyte sedimentation rate is noted 24 hours after an increase in temperature and an increase in the number of leukocytes.

The ESR indicator varies depending on many physiological and pathological factors. The values of ESR in women are slightly higher than in men. Changes in the protein composition of the blood during pregnancy lead to an increase in ESR during this period. During the day, fluctuations in values are possible, the maximum level is noted in the daytime.

Indications for the appointment of the study:

inflammatory diseases;
infectious diseases;
tumors;
screening examination during preventive examinations.

When does ESR accelerate?

Inflammatory diseases of various etiologies.
Acute and chronic infections (pneumonia, osteomyelitis, tuberculosis, syphilis).
Paraproteinemias (multiple myeloma, Waldenström's disease).
Tumor diseases (carcinoma, sarcoma, acute leukemia, lymphogranulomatosis, lymphoma).
Autoimmune diseases (collagenoses).
Kidney disease (chronic nephritis, nephrotic syndrome).
Myocardial infarction.
Hypoproteinemia.
Anemia, condition after blood loss.
Intoxication.
Trauma, broken bones.
Condition after shock, surgical interventions.
Hyperfibrinogenemia.
In women during pregnancy, menstruation, in the postpartum period.
Elderly age.
Taking medications (estrogens, glucocorticoids).

When does ESR slow down?

Erythremia and reactive erythrocytosis.
Severe symptoms of circulatory failure.
Epilepsy.
Starvation, loss of muscle mass.
Taking corticosteroids, salicylates, calcium and mercury preparations.
Pregnancy (especially 1st and 2nd semester).
Vegetarian diet.
Myodystrophy.

What is the leukocyte formula (Differential White Cell Count)?

The leukocyte formula is the percentage of different types of leukocytes.

According to morphological features (type of nucleus, presence and nature of cytoplasmic inclusions), 5 main types of leukocytes are distinguished:

neutrophils;
eosinophils;
basophils;
lymphocytes;
monocytes.

In addition, leukocytes differ in their degree of maturity. Most of the progenitor cells of mature forms of leukocytes (young, myelocytes, promyelocytes, prolymphocytes, promonocytes, blast cells) appear in the peripheral blood only in case of pathology.

The study of the leukocyte formula is of great importance in the diagnosis of most hematological, infectious, inflammatory diseases, as well as for assessing the severity of the condition and the effectiveness of the therapy.

The leukocyte formula has age-specific features (in children, especially during the neonatal period, the ratio of cells differs sharply from adults).

About 60% of the total number of granulocytes is located in the bone marrow, making up the bone marrow reserve, 40% - in other tissues, and only less than 1% - in peripheral blood.

Different types of leukocytes perform different functions, therefore, determining the ratio of different types of leukocytes, the content of young forms, and identifying pathological cellular forms carries valuable diagnostic information.

Possible options for changing (shifting) the leukocyte formula:

shift of the leukocyte formula to the left - an increase in the number of immature (stab) neutrophils in the peripheral blood, the appearance of metamyelocytes (young), myelocytes;

shift of the leukocyte formula to the right - a decrease in the normal number of stab neutrophils and an increase in the number of segmented neutrophils with hypersegmented nuclei (megaloblastic anemia, kidney and liver diseases, condition after blood transfusion).

What are neutrophils?

Neutrophils are the most numerous type of white blood cells, they make up 45-70% of all leukocytes. Depending on the degree of maturity and shape of the nucleus in the peripheral blood, stab (younger) and segmented (mature) neutrophils are isolated. Younger cells of the neutrophilic series - young (metamyelocytes), myelocytes, promyelocytes - appear in the peripheral blood in case of pathology and are evidence of stimulation of the formation of cells of this type. The duration of circulation of neutrophils in the blood is on average about 6.5 hours, then they migrate to the tissues.

They participate in the destruction of infectious agents that have entered the body, closely interacting with macrophages (monocytes), T- and B-lymphocytes. Neutrophils secrete substances that have bactericidal effects, promote tissue regeneration, removing damaged cells from them and secreting substances that stimulate regeneration. Their main function is protection against infections by chemotaxis (directed movement to stimulating agents) and phagocytosis (absorption and digestion) of foreign microorganisms.

An increase in the number of neutrophils (neutrophilia, neutrophilia, neutrocytosis), as a rule, is combined with an increase in the total number of leukocytes in the blood. A sharp decrease in the number of neutrophils can lead to life-threatening infectious complications. Agranulocytosis is a sharp decrease in the number of granulocytes in the peripheral blood up to their complete disappearance, leading to a decrease in the body's resistance to infection and the development of bacterial complications.

When can there be an increase in the total number of neutrophils (neutrophilia, neutrophilia)?

When does an increase in the number of immature neutrophils occur (left shift)?

In this situation, the number of stab neutrophils in the blood increases, the appearance of metamyelocytes (young), myelocytes is possible.

This may be when:

acute infectious diseases;
metastases of malignant neoplasms of various localization;
the initial stage of chronic myeloid leukemia;
tuberculosis;
myocardial infarction;
intoxication;
state of shock;
physical stress;
acidosis and coma.

When does a decrease in the number of neutrophils (neutropenia) occur?

Bacterial infections (typhoid, paratyphoid, tularemia, brucellosis, subacute bacterial endocarditis, miliary tuberculosis).
Viral infections (infectious hepatitis, influenza, measles, rubella, chicken pox).
Malaria.
Chronic inflammatory diseases (especially in the elderly and debilitated people).
Renal failure.
Severe forms of sepsis with the development of septic shock.
Hemoblastoses (as a result of hyperplasia of tumor cells and reduction of normal hematopoiesis).
Acute leukemia, aplastic anemia.
Autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, chronic lymphocytic leukemia).
Isoimmune agranulocytosis (in newborns, post-transfusion).
Anaphylactic shock.
Splenomegaly.
Hereditary forms of neutropenia (cyclic neutropenia, familial benign chronic neutropenia, Kostmann's permanent hereditary neutropenia).
ionizing radiation.
Toxic agents (benzene, aniline, etc.).
Deficiency of vitamin B12 and folic acid.
Taking certain medications (pyrazolone derivatives, non-steroidal anti-inflammatory drugs, antibiotics, especially chloramphenicol, sulfa drugs, gold preparations).
Taking anticancer drugs (cytostatics and immunosuppressants).
Alimentary-toxic factors (eating spoiled overwintered cereals, etc.).

What are eosinophils?

When does the number of eosinophils increase (eosinophilia)?

What are Basophils?

The smallest population of leukocytes. Basophils account for an average of 0.5% of the total number of blood leukocytes. In blood and tissue basophils (the latter also include mast cells) they perform many functions: they support blood flow in small vessels, promote the growth of new capillaries, and ensure the migration of other leukocytes into tissues. They participate in delayed-type allergic and cellular inflammatory reactions in the skin and other tissues, causing hyperemia, exudate formation, and increased capillary permeability. Basophils during degranulation (destruction of granules) initiate the development of an anaphylactic hypersensitivity reaction of an immediate type. Contain biologically active substances (histamine; leukotrienes that cause smooth muscle spasm; “platelet activating factor”, etc.). The life span of basophils is 8-12 days, the time of circulation in the peripheral blood (as in all granulocytes) is several hours.

When does an increase in the number of basophils (basophilia) occur?

Allergic reactions to food, drugs, the introduction of a foreign protein.
Chronic myeloid leukemia, myelofibrosis, erythremia, lymphogranulomatosis.
Hypothyroidism (hypothyroidism).
Nephritis.
Chronic ulcerative colitis.
hemolytic anemia.
Iron deficiency, after treatment of iron deficiency anemia.
B12 deficiency anemia.
Conditions after splenectomy.
In the treatment of estrogens, antithyroid drugs.
During ovulation, pregnancy, at the beginning of menstruation.
Lungs' cancer.
True polycythemia.
Diabetes.
Acute hepatitis with jaundice.
Ulcerative colitis.
Hodgkin's disease.

What are Lymphocytes?

Lymphocytes make up 20-40% of the total number of leukocytes. Lymphocytes are formed in the bone marrow and actively function in the lymphoid tissue. The main function of lymphocytes is to recognize a foreign antigen and participate in an adequate immunological response of the body. Lymphocytes are a uniquely diverse population of cells originating from various precursors and united by a single morphology. By origin, lymphocytes are divided into two main subpopulations: T-lymphocytes and B-lymphocytes. There is also a group of lymphocytes called "neither T- nor B-", or "0-lymphocytes" (null lymphocytes). The cells that make up this group are identical in morphological structure to lymphocytes, but differ in origin and functional features - immunological memory cells, killer cells, helpers, suppressors.

Different subpopulations of lymphocytes perform different functions:

ensuring effective cellular immunity (including transplant rejection, destruction of tumor cells);

the formation of a humoral response (the synthesis of antibodies to foreign proteins - immunoglobulins of different classes);

regulation of the immune response and coordination of the work of the entire immune system as a whole (isolation of protein regulators - cytokines);

providing immunological memory (the body's ability to accelerate and enhance the immune response upon re-encounter with a foreign agent).

It must be borne in mind that the leukocyte formula reflects the relative (percentage) content of leukocytes of various types, and an increase or decrease in the percentage of lymphocytes may not reflect true (absolute) lymphocytosis or lymphopenia, but may be the result of a decrease or increase in the absolute number of leukocytes of other types (usually neutrophils ).

When can the number of lymphocytes increase (lymphocytosis)?

Viral infection (infectious mononucleosis, acute viral hepatitis, cytomegalovirus infection, whooping cough, SARS, toxoplasmosis, herpes, rubella, HIV infection).
Acute and chronic lymphocytic leukemia, Waldenström's macroglobulinemia, lymphomas during the period of leukemization.
Tuberculosis.
Syphilis.
Brucellosis.
Poisoning with tetrachloroethane, lead, arsenic, carbon disulfide.
When taking certain medications (levodopa, phenytoin, valproic acid, narcotic analgesics, etc.).

When can the number of lymphocytes decrease (lymphopenia)?

Acute infections and diseases.
The initial stage of the infectious-toxic process.
Severe viral diseases.
miliary tuberculosis.
Systemic lupus erythematosus.
Aplastic anemia.
Terminal stage of oncological diseases.
Secondary immune deficiencies.
Renal failure.
Circulatory failure.
X-ray therapy. Taking drugs with a cytostatic effect (chlorambucil, asparaginase), glucocorticoids, administration of antilymphocyte serum

.What are monocytes?

Monocytes are the largest cells among leukocytes (a system of phagocytic macrophages), accounting for 2-10% of all leukocytes. Monocytes are involved in the formation and regulation of the immune response. In tissues, monocytes differentiate into organ- and tissue-specific macrophages. Monocytes/macrophages are capable of amoeboid movement, exhibit pronounced phagocytic and bactericidal activity. Macrophages - monocytes are able to absorb up to 100 microbes, while neutrophils - only 20-30. In the focus of inflammation, macrophages phagocytize microbes, denatured protein, antigen-antibody complexes, as well as dead leukocytes, damaged cells of inflamed tissue, clearing the focus of inflammation and preparing it for regeneration. They secrete more than 100 biologically active substances. Stimulate the factor that causes tumor necrosis (cachexin), which has cytotoxic and cytostatic effects on tumor cells. Secreted interleukin I and cachexin act on the thermoregulatory centers of the hypothalamus, increasing body temperature. Macrophages are involved in the regulation of hematopoiesis, immune response, hemostasis, lipid and iron metabolism. Monocytes are formed in the bone marrow from monoblasts. After leaving the bone marrow, they circulate in the blood from 36 to 104 hours, and then migrate to the tissues. In tissues, monocytes differentiate into organ- and tissue-specific macrophages. Tissues contain 25 times more monocytes than blood.

When does the number of monocytes increase (monocytosis)?

Viral infections (infectious mononucleosis).
Fungal, protozoal infections (malaria, leishmaniasis).
Recovery period after acute infections.
Granulomatosis (tuberculosis, syphilis, brucellosis, sarcoidosis, ulcerative colitis).
Collagenosis (systemic lupus erythematosus, rheumatoid arthritis, periarteritis nodosa).
Blood diseases (acute monoblast and myelomonoblastic leukemia, chronic monocytic and myelomonocytic myeloid leukemia, lymphogranulomatosis).
Subacute septic endocarditis.
Enteritis.
Sluggish sepsis.
Poisoning with phosphorus, tetrachloroethane.

When does the number of monocytes decrease (monocytopenia)?

Aplastic anemia.
Childbirth.
Operational interventions.
shock states.
Hairy cell leukemia.
pyogenic infections.
Taking glucocorticoids.

What are reticulocytes?

Reticulocytes are young forms of erythrocytes (predecessors of mature erythrocytes) containing a granular-filamentous substance, which is detected with a special (supravital) stain. Reticulocytes are found both in the bone marrow and in the peripheral blood. The maturation time of reticulocytes is 4-5 days, of which within 3 days they mature in the peripheral blood, after which they become mature erythrocytes. In newborns, reticulocytes are found in greater numbers than in adults.

The number of reticulocytes in the blood reflects the regenerative properties of the bone marrow. Their count is important for assessing the degree of activity of erythropoiesis (erythrocyte production): when erythropoiesis is accelerated, the proportion of reticulocytes increases, and when it slows down, it decreases. In the case of increased destruction of erythrocytes, the proportion of reticulocytes may exceed 50%. A sharp decrease in the number of erythrocytes in the peripheral blood can lead to an artificial increase in the number of reticulocytes, since the latter is calculated as a percentage of all erythrocytes. Therefore, to assess the severity of anemia, the "reticular index" is used: % reticulocytes x hematocrit / 45 x 1.85, where 45 is normal hematocrit, 1.85 is the number of days required for new reticulocytes to enter the blood. If index< 2 - говорит о гипопролиферативном компоненте анемии, если >2-3, then there is an increase in the formation of red blood cells.

Indications for the purpose of the analysis:

diagnosis of ineffective hematopoiesis or reduced production of red blood cells;
differential diagnosis of anemia;
assessment of response to therapy with iron, folic acid, vitamin B12, erythropoietin;
monitoring the effect of bone marrow transplantation;
monitoring therapy with erythrosuppressors.

When does the number of reticulocytes increase (reticulocytosis)?

Posthemorrhagic anemia (reticulocytic crisis, 3-6 times increase).
Hemolytic anemia (up to 300%).
Acute lack of oxygen.
Treatment of B12-deficiency anemia (reticulocyte crisis on days 5-9 of vitamin B12 therapy).
Therapy of iron deficiency anemia with iron preparations (8-12 days of treatment).
Thalassemia.
Malaria.
Polycythemia.
Metastases of tumors in the bone marrow.

When does the number of reticulocytes decrease?

Aplastic anemia.
hypoplastic anemia.
Untreated B12 deficiency anemia.
Metastases of neoplasms in the bone.
Autoimmune diseases of the hematopoietic system.
Myxedema.
Kidney diseases.
Alcoholism.

The erythrocyte sedimentation rate (ESR) is an indicator that determines the speed and intensity of erythrocyte agglutination in certain pathological processes. This analysis is one of the mandatory values of the general blood test, previously the analysis was called ROE and determined the reaction of erythrocyte sedimentation.

Changes and deviations from the norm indicate inflammation and the development of the disease. That is why, in order to stabilize the ESR, the disease is initially treated, and not artificially attempted to achieve the norm with the help of drugs.

As a rule, excess of the norm indicates a violation of the electrochemical structure of the blood, as a result of which pathological proteins (fibrinogens) attach to red blood cells. The appearance of such elements occurs against the background of bacterial, viral, infectious and fungal lesions, inflammatory processes.

Indications

Important! ESR is a non-specific indicator. This means that in isolation from other data, on the basis of ESR alone, it is impossible to make a diagnosis. Deviations in the erythrocyte sedimentation rate indicate only the presence of pathological changes.

An ESR analysis is a necessary step in diagnosing the structure of the blood, which at the earliest stages of the disease makes it possible to determine the presence of inflammatory processes in the body.

That is why ESR is prescribed for suspected pathologies of various nature:

inflammatory diseases;
infectious;
benign and malignant formations.

Additionally, screening is carried out at annual medical examinations.

ESR is used in the complex of clinical (general) analysis. After it, it is necessary to additionally use other diagnostic methods.

Even minor deviations from the norm must be considered conditionally pathological, requiring additional examination.

If a pathology of the hematopoietic system is suspected, the analysis of ESR becomes the main diagnostic value.

ESR norms

The erythrocyte sedimentation rate is measured in mm per hour.

ESR according to Westergren, ESR micromethod - venous blood is examined

ESR according to Panchenkov - capillary blood is examined (from a finger)

Depending on the type, form of the course (acute, chronic, recurrent) and the stage of development of the disease, ESR can change dramatically. To obtain a complete picture, a second study is carried out after 5 days.

ESR above normal

Important! A physiological increase in ESR can be observed in women during menstruation, during pregnancy and in the postpartum period.

As a rule, the erythrocyte sedimentation rate exceeds the norm in the following diseases:

inflammatory processes of various etiologies. The indicator increases as a result of increased production of globulins and fibrinogens during the acute phase of inflammation;
decay, tissue death, necrotic processes in cells. As a result of the breakdown, protein products enter the bloodstream, causing sepsis and purulent processes. This group includes oncological pathologies, tuberculosis, heart attacks (of the brain, myocardium, lungs, intestines), etc.;
metabolic disorders - hypo- and hyperthyroidism, diabetes at all stages, etc.;
nephrotic syndrome and hypoalbuminemia, liver pathology, severe blood loss, exhaustion;
anemia (anemia), hemolysis, blood loss and other pathologies of the circulatory system. As a result of the disease, the number of red blood cells in the body is reduced .;
vasculitis, connective tissue diseases: arthritis, periarteritis, scleroderma, rheumatism, lupus and many others;
hemoblastosis of all types (leukemia, Waldenström's disease, lymphogranulomatosis and others);
periodic hormonal changes in the female body (menstruation, childbearing and childbirth, the onset of menopause).

ESR below normal

Registered in the following cases:

disorders of the circulatory system associated with the production of red blood cells (erythremia, erythrocytosis, etc.), changes in their shape (hemoglobinopathy, spherocytosis, sickle cell anemia, and others);
prolonged fasting, dehydration;
congenital or hereditary circulatory failure;
violation of the nervous system: epilepsy, stress, neuroses, as well as mental disorders;
regular intake of certain medications: calcium chloride, salicylates, preparations containing mercury.

Upon receipt of the results of ESR, you need to contact a therapist who will decipher them and refer them to a highly specialized doctor (infectious disease specialist, hematologist, oncologist, immunologist, and others).

Self-medication and an attempt to artificially stabilize the ESR level will not give results, but will blur the picture for further research and competent therapy.

How to prepare for the procedure

A general blood test (within which ESR is detected) is carried out in the morning on an empty stomach. That is, between the last snack and the blood sampling procedure, about 8-10 hours should pass.

1-2 days before blood donation, it is necessary to give up alcohol, “heavy” food (fried, fatty, smoked), hot spices.

A couple of hours before the procedure, you should refrain from smoking (cigarettes, hookah, pipes, electronic cigarettes, etc.).

Severe stress, psychological stress, physical activity (running, climbing stairs, carrying weights) can also affect the level of red blood cells. Immediately before the manipulations, you need to rest for 30-60 minutes.

You should also tell your doctor about any medications you take regularly or on demand. Their active substances can affect the result of the analysis.

Keep in mind that each laboratory uses different methods of testing ESR and units of measurement. Therefore, it is necessary to do an analysis, undergo further (repeated) examination and treatment in the same hospital.

Method of determination See description.

Important! The results obtained by the Panchenkov and Westergren methods coincide in the region of normal values, in the zone of elevated values, the results obtained by the Westergren method are usually higher than those obtained by the Panchenkov method.

Material under study See in the description

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A nonspecific indicator that reflects changes in the protein composition of blood plasma. It is mainly used to diagnose inflammatory conditions and monitor their course. The classical principle of measuring ESR is that when a certain volume of blood mixed with sodium citrate is placed in a vertically standing test tube or capillary, the erythrocytes will sink down under the influence of gravity, while the repulsive forces that arise between the negatively charged erythrocyte membranes will to prevent this settling. The ESR value is measured as the height of the plasma column above the formed elements, formed in 1 hour. Accordingly, the units of ESR are millimeters per hour (mm/hour). With the appearance in the blood plasma of a large number of proteins of the acute phase of inflammation, which include fibrinogen, C-reactive protein, alpha and gamma globulins, etc., or paraproteins, the repulsive force between the erythrocytes decreases, and the erythrocytes settle faster. The erythrocyte sedimentation rate is also affected by their morphology (poikilocytosis of the erythrocytes of the test sample leads to an underestimation of the ESR, smoothing the shape of the erythrocytes, on the contrary, can accelerate the ESR), as well as the hematocrit value (a decrease in hematocrit leads to an overestimation of the ESR). In acute inflammatory diseases, ESR usually rises a day after the onset of the disease, while the normalization of this indicator after recovery is slower, and can take from several days to two or more weeks. Also in modern laboratory practice, modified methods for measuring ESR are used to speed up and automate the performance of this test. Using a mathematical algorithm, the results obtained by these methods are reduced to the scales of classical methods (according to Westergren and Panchenkov), and are also given in the usual units, mm/hour. In INVITRO, three methods are used to study ESR: ESR from venous blood in INVITRO is performed from separate tubes with sodium citrate, using an automatic ESR analyzer SRS II (Greiner Bio-One, Austria). In cases where this is not possible, the study can be performed by the micromethod (TEST1, Alifax, Italy) or by Panchenkov from EDTA-stabilized blood.

Comparison of ESR methods used in INVITRO

From capillary blood in INVITRO, ESR is performed only according to the Panchenkov method (measurement scale - 100 mm). In any case, the method by which the study was conducted is indicated when the result is issued.

The erythrocyte sedimentation rate (ESR) is one of the indicators of a general and detailed blood test. There are several ways to measure this indicator. Analysis of ESR according to Panchenkov is one of them. This is a special test that makes it possible to determine the presence of inflammation, malignant tumors and diffuse diseases.

What is the Panchenkov method based on?

The proportion of red blood cells in the blood is the largest compared to other components. If the state of the body changes, then the response to the stimulus is an increase in the concentration of specific proteins. It is they who glue red blood cells together, forming red coin-like columns.

The united blood cells become heavier, respectively, and the rate of their settling increases. It was this physiological process that became the basis of the method for determining the presence of pathological processes in the body by a blood test.

Erythrocytes begin to settle faster on the second day after the onset of the disease. This rate gradually increases, reaching a peak in the second week. There are times when the highest rate falls on the recovery period.

A one-time analysis does not give a complete clinical picture of the patient's condition. Therefore, along with the ESR, other indicators are also determined, and the particle velocity is re-measured after a while.

The definition of ESR according to Panchenkov involves the use of chemical reagents, in particular sodium citrate. This substance prevents clotting. A chemical solution is added to the capillary blood. A test tube with this "cocktail" is placed vertically for 60 minutes. In response to this exposure, erythrocytes settle to the bottom. The time during which they fell is considered the ESR.

As a result of the reaction, the hematopoietic material is divided into two parts:

the upper part is transparent plasma;
the bottom layer is red blood.

The tube is divided by a special scale. Using it, after an hour after sampling the biomaterial, the laboratory assistant calculates the height of the layer of descended hematopoietic cells. The speed value is indicated in mm/h.

The erythrocyte sedimentation rate (Panchenkov's method) is one of the components of a general or detailed blood test. No specialist will rely solely on it, diagnosing diseases.

The basis for the appointment of the procedure may be:

Scheduled preventive examination.
Poor health of the patient.
Infection.
Inflammation.
Oncological pathologies.

This examination can be carried out from a very early age (from birth).

ESR norms in children

As they grow older, the standard ESR values in children increase. The low level of sedimentation in infants is explained by the peculiarities of protein metabolism. Below is a table of average values.

In boys, this figure is usually lower than in girls. For example, in adolescence, for boys, this indicator is 1-10 mm / hour, and for girls - 2-15 mm / hour.

This value is also affected by the time of day. So, after dinner, the ESR is higher than in the morning or at night.

There are certain periods when ESR according to Panchenkov is increased in children:

28-31 days from the birth of the child.
Upon reaching two years.

At this time, the speed can reach 17 mm/hour.

Adult Guidelines

With age, the level of ESR in men and women increases with a certain trend: every 5 years - by 0.85 mm / h. There are several explanations for this phenomenon:

An increase in the content of fibrinogen (a transparent soluble protein, which is the basis for the formation of blood clots).
An increase in the number of diseases.

Therefore, the highest numerical values of erythrocyte sedimentation can be traced in people aged 65-74 years.

High ESR is considered normal in pregnant women. Moreover, in the I and II trimester, the indicator can be stable, and at the “finish line” it rises to 20 mm / h. The table shows the standards broken down by age and gender.

The reason for the high ESR

Above the norm, ESR most often occurs in infectious and inflammatory processes. In this case, the changes also affect other indicators of the general blood test. The reasons for the increase in the rate of red blood cells due to non-communicable diseases are:

Systemic ailments - rheumatoid arthritis, bronchial asthma.
Metabolic disorders - diabetes mellitus, hypothyroidism, hyperthyroidism.
Violation of the circulatory system.
Oncological pathologies.
Tuberculosis.
Injuries of a different nature.
body intoxication.
Malfunction of the genitourinary system or kidneys.

There is a small nuance: even after the disease has been defeated, erythrocyte sedimentation returns to normal for a long time. The recovery process may take 1-1.5 months. To make sure that the disease has left the body, you can pass.

If the indicators are elevated in a child, this does not mean that he is sick. There are a number of harmless factors that can trigger such changes:

A baby may have an increase in ESR due to the fact that a nursing mother eats a lot of fat or takes medications.
The child is teething.
In boys aged 4-12 years, an increased ESR value is observed from time to time.
Individual characteristics of the organism (in 5% of the population).
Iron deficiency in the body.

Analysis of ESR in the blood shows the likelihood of a person having a disease. Additional surveys need to be carried out to obtain accurate data..

How the analysis is done

The determination of ESR according to the Panchenkov method involves the use of capillary blood, so the sampling is carried out from a finger. From the equipment, an appropriate capillary is used - this is a pipette with a scale from 0 to 100 mm and two letter designations: "K" (blood) at the level of "100" and "P" (reagent) - at the number "50".

Research algorithm:

A solution of sodium citrate 5% up to the letter "P" is collected into the Panchenkov's capillary and poured into a test tube.
Using the same equipment, 2 blood samples are taken up to the letter “K” and blown into the same test tube.
The blood is mixed with the reagent and drawn into the capillary up to the “K” mark.
The capillary is placed vertically in a tripod.
A note is made of the installation of the capillary tube.
After 60 minutes, the laboratory assistant calculates the rate of separation of erythrocytes from plasma.
The data is entered in the appropriate form.

As you can see, the specialist starts the study immediately. Determination of ESR by the Panchenkov method requires strict adherence to technology.

The results are ready within 1 working day from the date of blood donation. In commercial medical organizations, everything happens more quickly, and after 2 hours the test results can be in the hands of the patient.

Abbreviations such as ROE, ESR or ESR may appear on the form. They all mean the same thing - the erythrocyte sedimentation rate. The data given are in mm/h. They can be compared with the table of averages by sex and age, which is given above.

Preparatory activities

A blood test using this technique involves a number of preparatory measures:

The last meal should be 8 hours before the delivery of the biomaterial. During this period, you can only drink water.
For 48 hours you need to follow a diet. Avoid spicy and fatty foods.
Before the procedure, exclude physical activities that contribute to the production of adrenaline: running, lifting weights, extreme sports.
15 minutes before the sampling of the material, you must sit quietly.

Certain medications can affect lab results, such as:

"Cortisone".
Oral contraceptives.
"Cyclophosphamide".

If it is impossible to refrain from using them even for a short period, then you should inform your doctor about this. He will correct the received data, taking into account the information received.

Compliance with all these rules will help to obtain an objective assessment of the patient's condition and timely diagnose the disease.

What to do to reduce ESR

To normalize the increased rate of erythrocyte sedimentation, you can resort to drug therapy or alternative medicine. There are many ways. Here is a short list:

Drink decoctions of medicinal herbs that have an anti-inflammatory effect on the body (linden, chamomile).
Give preference to hot drinks (tea with honey, lemon or raspberries).
Refuse semi-finished products and products containing carcinogens.
Citrus fruits, fresh vegetables, dark chocolate have a beneficial effect. Red beets are considered the most effective.
Take complex vitamins containing iron, magnesium and vitamin A.
Sports exercises in tandem with breathing exercises will help make the blood less viscous.
The causes of the acceleration of blood particles should be dealt with. So, with infection or inflammation, Penicillin, Levomycetin, Tetracycline help.
There are conditions of the body in which ESR will return to normal on its own when the cause disappears (pregnancy, teething in a child).
Recommend also the adoption of "Aspirin". It inhibits the synthesis of substances, so its use is advisable only in exceptional cases.

There are many methods to reduce this indicator. But it is better not to resort to the medical method without the consent of the attending physician.

The advantage of the Panchenkov method

The setting of ESR can be carried out by different methods. The most popular are studies according to Panchenkov and according to the system. Each of them has its own advantages.

The method of measuring erythrocyte sedimentation according to Panchenkov has been successfully used in Russia and the CIS countries for many years. It is a kind of modification of the Westergren technique.

The pipette with reverse graduation was replaced with a Panchenkov capillary. This dosing device is used for both blood and reagent.

The definition of ESR according to Panchenkov implies the use of capillary blood, and not venous, which makes the method less painful and facilitates the collection of biomaterial in children.

The study is carried out immediately. Immediately the blood is diluted with a reagent, which eliminates the impact of negative factors.

This technique, subject to all technologies, is fast and does not require a large amount of biomaterial.