Clinical blood test - this is the study that is prescribed most often. It is carried out to assess the general he alth of a person. One of the non-specific indicators is the ESR - the erythrocyte (red blood cell) sedimentation rate. It can change under the influence of various factors. An ESR of 4 mm/h, as a rule, does not indicate the presence of a pathological process in the body. However, when interpreting the results, the gender and age of the patient must be taken into account. For example, the ESR norm in a child at 4 years old differs from generally accepted indicators for adults.
Erythrocyte sedimentation rate: concept
Red blood cells are the heaviest shaped elements of liquid connective tissue. If you place the biological material in a test tube and put it vertically, after a while it will begin to separate into fractions. In this case, the plasma will be on top, and the erythrocytes will be in the form of a sediment at the bottom of the container. The division of blood into fractions occurs under the influence of gravitational forces.
Besides, erythrocytes have one peculiarity. Atbeing in certain conditions starts the process of formation of a complex of cells. In other words, they stick together. It is logical that the mass of the whole complex is greater than that which is characteristic of one cell. Therefore, it will settle to the bottom of the tube faster.
With the development of any pathological process in the body, the rate of formation of complexes increases or, on the contrary, decreases. Accordingly, the ESR indicator also deviates from the norm in one direction or another. The erythrocyte sedimentation rate is determined in mm/h.
Normal indicators for women
It is important to remember that each organism is individual. However, the ESR values found in the majority of patients (95%) are now considered generally accepted. A slight deviation is acceptable, but even in this case it is necessary to find out the cause of this condition.
Clinical blood test is always carried out as part of preventive examinations. In addition, testing is ordered for women with the following symptoms:
- Signs of anemia.
- Disturbance of appetite (up to its complete absence).
- Pain in the head, neck, shoulders, as well as in the pelvic organs and joints.
- Weight loss for no apparent reason.
The table below shows the generally accepted indicators for women.
| Age | Normal values expressed in mm/h |
| 13-16 years old | 7 to 10 |
| 17-18 years old | From 15 to 18 |
| 19-50 years old | From 2 to 15 |
| 51 and older | From 15 to 20 |
As can be seen from the table, at different ages, the norm indicators change. If the ESR is 4 mm / h in the blood test, women from 19 to 50 years old should not worry. In this case, the indicator indicates the absence of pathological processes in the body.
For adolescents and older women, ESR 4 is not the norm. In this case, it is customary to speak of a decrease in the erythrocyte sedimentation rate. This may be due not only to certain diseases, but also to natural physiological processes. In addition, a number of other factors must be taken into account, including non-compliance with the rules for preparing for the study.
In pregnant women, ESR 4 is definitely not an indicator of the norm. In the first half of the gestational period, the sedimentation rate of red blood cells should vary between 21-62 mm / h. For women of full build, the norm is from 18 to 48 mm / h. In the second half of pregnancy, the indicator should be from 40 to 65 mm / h. For obese women - from 30 to 70 mm / h.
Normal indicators for men
ESR values in men also change with age. The norm indicators are shown in the table below.
| Age, years | Normal values, mm/h |
| 18-20 | From 2 to 10 |
| 21-50 | From 2 to 10 |
| 51 and older | From 2 to 12 (up to 20 if the study wascarried out by the Westergren method, information about it is presented below) |
Thus, if a man as a result of the analysis saw that the ESR indicator is 4, you should not worry. This conclusion can be considered ideal.
Normal indicators for children
In this case, generally accepted values change quite significantly as the child grows up. For children, a clinical blood test is prescribed much more often than for adults. This is due to the fact that the doctor needs to evaluate the positive dynamics in ARVI, acute respiratory infections and other things. In addition, the study is prescribed as part of a preventive examination before entering a kindergarten, school and other educational institutions.
A newly born baby should not have an ESR of 4 mm/h. This value indicates an increase in the erythrocyte sedimentation rate. 1-2 mm / h is the norm in children. An ESR of 4 mm/h in a newborn may indicate high hematocrit, hypercholesterolemia, and acidosis.
Babies have their first routine check-up at the age of 3 months. During this period, ESR 4 in the analysis is also not a variant of the norm. In babies from 1 month to six months, the erythrocyte sedimentation rate should vary between 12-17 mm / h.
At 1-4 years old, the ESR rate in children is from 1 to 8 mm / h. That is, an indicator of 4 mm / h at this age does not indicate the development of any pathological process.
Blood sampling
As a biological material, capillaryfluid connective tissue. The process of taking it from both the finger and the vein takes only a couple of minutes. The study does not involve any special preparatory activities. The only condition is that you need to donate blood on an empty stomach. The last meal should take place no earlier than 4 hours before the collection of biological material.
Panchenkov blood test
This method is the most common in Russia. Capillary blood is required for the study. Initially, liquid connective tissue is collected in a thin glass tube, on which divisions are applied. The next step is to mix the blood on a glass slide with an anticoagulant in a ratio of 1:4. This is necessary so that the connective tissue does not curl up.
Then the blood is drawn back into the tube (capillary). After that, you need to wait 1 hour. After 60 minutes, the laboratory assistant measures the height of the column of plasma separated from the erythrocytes. The resulting indicator is the ESR.
Westergren blood test
This method of research is used all over the world (in Russia, doctors are more accustomed to the previous one). The essence of the method remains the same. The difference lies in the fact that venous blood is used as biological material. In addition, a more accurate scale is used during analysis.
Factors affecting the result
The study is not specific. Upon receipt of a result that deviates from the norm up or down, a biochemicalblood test. In other words, even if the result is erroneous, it can be confirmed or ruled out with the help of another study.
The accuracy of the analysis directly depends on the following factors:
- Patient preparation. It is not difficult, it is enough just not to eat for 4 hours before donating blood.
- Laboratory qualifications. In this case, the human factor plays a role.
- Quality of reagents, in this case anticoagulants.
When a result is too low or very high for no apparent reason, the doctor issues a referral for a second clinical study, as well as a biochemical one.
Reasons for increased ESR
This situation does not always indicate pathology. Initially, it is necessary to exclude other factors that can lead to a deviation of the indicator from the norm upwards.
Non-pathological causes:
- Using combined oral contraceptives.
- Fasting.
- Long-term adherence to a strict low-calorie diet.
- Not drinking enough water.
- Meal less than 4 hours before donation.
- High-intensity physical activity on the eve of biomaterial sampling.
During the interpretation of the results, the doctor initially takes into account the age of the patient. As mentioned above, an ESR at 4 years old, for example, is not a good indicator for teenagers.
Pathological causes of increased settling rateerythrocytes:
- Infectious diseases accompanied by inflammatory processes (pneumonia, syphilis, rheumatism, tuberculosis, blood poisoning). The ESR indicator during the active life of bacteria increases much more than during the reproduction of viruses.
- Diabetes mellitus.
- Thyrotoxicosis.
- Rheumatoid arthritis.
- Inflammatory damage to the heart muscle.
- Liver disease.
- Pathologies of the kidneys.
- Pancreas lesion.
- Intestinal diseases.
- Poisoning the body with arsenic or lead.
- Malignant neoplasms.
- Myeloma.
- Anemia.
- Lymphogranulomatosis.
- Increased concentration of "bad" cholesterol in the blood.
In addition, the ESR indicator changes upwards after receiving various kinds of injuries. It also rises when taking certain medications, such as Methyldorf or Dextran.
Reason for the decline
In this case, it is customary to talk about the lack of ability of erythrocytes to form complexes from cells.
Main reasons for the downward trend in the indicator:
- Increased blood viscosity.
- Decrease in the pH of fluid connective tissue.
- Change in the shape of red blood cells.
- Mechanical jaundice.
- Sickle cell anemia.
- Elevated levels of bilirubin in the blood.
- Low concentrationfibrinogen in fluid connective tissue.
- Reactive erythrocytosis.
- Circulatory disorders of a chronic nature.
- Erythremia.
In addition, a decrease in the rate of erythrocyte sedimentation may be the result of taking hormonal drugs, following a vegetarian diet, starvation. Also, the indicator deviates from the norm downward during the I and II trimester of pregnancy.
In closing
CBC is the most frequently ordered laboratory test. Its implementation is indicated both in the presence of patient complaints about their well-being, and as part of preventive examinations. One of the clinically significant indicators is the erythrocyte sedimentation rate. The ESR value of 4 mm/h in most cases does not indicate the development of a pathological process in the patient's body. During the interpretation of the results, the doctor takes into account not only the age, but also the gender of the patient. If the indicator deviates in one direction or another, the specialist should initially exclude non-pathological causes.
