現在位置 : RA > 紅血球沉降率 Erythrocyte Sedimentation Rate - ESR
紅血球沉降率 (Erythrocyte Sedimentation Rate，ESR)，也稱為Biernacki反應，簡稱血沉，是指血紅血球在1小時內沉降的速率。紅血球沉降率是一個非常常見的血液學測試，是炎症反應的非特異性測量指標。測量時，我們將抗凝血液放置在直立管 (稱為Westergren管)，並記錄紅血球沉降的距離，以毫米/小時(mm/h)為單位報告紅血球的沉降率。現在紅血球沉降率測試通常都是由臨床實驗室的自動化分析儀自動執行。
紅血球沉降率測試是在1897年由波蘭醫生埃德蒙·比爾奈伊(Edmund Biernacki)發明。在世界上的一些地區，紅血球沉降率測試仍然被稱為Biernacki測試。1918年，瑞典病理學家羅伯特·法利伍斯(Robert Sanno Fåhræus)使用檸檬酸鈉凝固樣本測試紅血球沉降率，阿爾夫·威廉·阿爾伯特森·魏斯特格倫(Alf Vilhelm Albertsson Westergren)對方法進行改良，因此紅血球沉降率測試有時也稱為法-魏氏測試 (簡稱為魏氏測試)，是現在測定紅血球沉降率的標準方法。
年齡 20 55 90
男性 12 20 19
女性 18 21 23
新生兒：0 - 2毫米/時
新生兒至青春期：3 - 13毫米/時（也有一些研究將正常上限值定為20毫米/時）
Erythrocyte Sedimentation Rate (ESR)
The erythrocyte sedimentation rate (ESR), also called a sedimentation rate or Westergren ESR, is the rate at which red blood cells sediment in a period of one hour. It is a common hematology test, and is a non-specific measure of inflammation. To perform the test, anticoagulated blood is placed in an upright tube, known as a Westergren tube, and the rate at which the red blood cells fall is measured and reported in mm/h.
Since the introduction of automated analyzers into the clinical laboratory, the ESR test has been automatically performed.
The ESR is governed by the balance between pro-sedimentation factors, mainly fibrinogen, and those factors resisting sedimentation, namely the negative charge of the erythrocytes (zeta potential). When an inflammatory process is present, the high proportion of fibrinogen in the blood causes red blood cells to stick to each other. The red cells form stacks called 'rouleaux,' which settle faster. Rouleaux formation can also occur in association with some lymphoproliferative disorders in which one or more immunoglobulins are secreted in high amounts. Rouleaux formation can, however, be a normal physiological finding in horses, cats, and pigs.
The ESR is increased by any cause or focus of inflammation. The ESR is increased in pregnancy, inflammation, anemia or rheumatoid arthritis, and decreased in polycythemia, sickle cell anemia, hereditary spherocytosis, and congestive heart failure. It may be increased in kidney cancer. The basal ESR is slightly higher in females.
It can sometimes be useful in diagnosing some diseases, such as multiple myeloma, temporal arteritis, polymyalgia rheumatica, various auto-immune diseases, systemic lupus erythematosus, rheumatoid arthritis, and chronic kidney diseases. In many of these cases, the ESR may exceed 100 mm/hour.
It is commonly used for a differential diagnosis for Kawasaki's disease and it may be increased in some chronic infective conditions like tuberculosis and infective endocarditis.
It is a component of the PCDAI (Pediatric Crohn's Disease Activity Index), an index for assessment of severity of inflammatory bowel disease in children.
Monitoring response to therapy
The clinical usefulness of ESR is limited to monitoring the response to therapy in certain inflammatory diseases such as temporal arteritis, polymyalgia rheumatica and rheumatoid arthritis. It can also be used as a crude measure of response in Hodgkin's lymphoma. Additionally, ESR levels are used to define one of the several possible adverse prognostic factors in the staging of Hodgkin's lymphoma.
Note: mm/hr. = millimeters per hour.
Westergren's original normal values (men 3mm and women 7mm) made no allowance for a person's age and in 1967 it was confirmed that ESR values tend to rise with age and to be generally higher in women. Values are increased in states of anemia, and in black populations.
What Is the Difference Between an ESR and CRP Test?
The erythrocyte sedimentation rate (ESR) test and the C-reactive protein (CRP) test are laboratory blood tests that healthcare professionals use to detect and monitor inflammation in the body. Both ESR and CRP are increased in the presence of acute inflammatory conditions, such as rheumatoid arthritis, polymyalgia rheumatica, inflammatory bowel disease, and other autoimmune conditions. The ESR measures the rate at which red blood cells separate from the fluid component of blood, the serum, with an increased rate of separation indicative of increased blood protein levels of fibrinogen, immunoglobulins, and other chemical agents that are present in inflammatory states. On the other hand, CRP measures the level of C-reactive protein, a substance that is generated by the liver in infectious or inflammatory situations. As a result, while both may indicate inflammation, ESR is an indirect sign of the condition and CRP is a direct indicator of it.
These tests are also useful to monitor the activity of autoimmune diseases and the patient's response to any medications that physicians prescribe to treat the condition. Changes in ESR are slower than changes in CRP, so it is a less sensitive indicator. In addition, many non-inflammatory conditions may elevate the ESR, such as anemia, menstruation, pregnancy, and use of a variety of medications. While both tests are readily available commercially, the ESR test is easier and less expensive than CRP.
Recent studies indicate that ESR tests may play a beneficial role in screening elderly patients for occult disease. A radical increase of the ESR strongly suggests a problem, most often an autoimmune disease, infection, or even a spreading cancer. Many patients with an ESR level exceeding 100 have myeloma, a condition in which certain white blood cells proliferate excessively and destroy body organs. As a result, a high level in an elderly patient may require further testing, such as additional blood and urine tests, chest X-rays, and liver function tests.
What Diet to Take if You Have a High ESR & High Lymphocytes?
Last Updated: Aug 16, 2013 By Ireland Wolfe
What Diet to Take if You Have a High ESR & High Lymphocytes?
Oranges and other citrus fruit are high in antioxidants. Photo Credit Liquidlibrary/liquidlibrary/Getty Images
ESR, or erythrocyte sedimentation rate, is a medical test that measures how much inflammation occurs throughout your body. A high lymphocyte count indicates an increase in white blood cells. There are many reasons that you may have a high ESR and lymphocycte count, and cancer and inflammation can cause both counts to be elevated. Consult your physician about any diet recommendations for your specific condition.
Your doctor may perform an ESR, also known as an sed rate, if you are experiencing certain symptoms of inflammation. Although the test cannot diagnose conditions, a measurement of ESR can establish a baseline to determine if your illness or symptoms are worsening. Your physician may use the test to monitor cancer, autoimmune disorders or inflammatory diseases. Lymphocytosis, or a high lymphocyte count, can indicate an infection, cancer of the blood or an autoimmune disorder that causes inflammation.
If your levels are elevated because of cancer, you may want to add foods to your diet that are high in antioxidants. Antioxidants attack free radicals, cells that cause damage to your body. Foods high in antioxidants help to prevent cancer but may also inhibit cancer cell growth. Foods rich in antioxidants include fruits and vegetables, such as avocados, cruciferous vegetables, carrots, peppers, raspberries, citrus fruit, grapes, kale, mushrooms and tomatoes. Other foods that may help to fight cancer include soy products, sweet potatoes, nuts, figs and flax and spices such as rosemary, garlic and turmeric.
Some people have high ESR and lymphocycte levels because of inflammation. There are foods that can help to reduce inflammation and other foods that you should avoid. Omega-3 fatty acids, found in the oil of fatty fish, can help to decrease inflammation in your body. Olive oil contains a type of antioxidant called polyphenols, which help to reduce or prevent inflammation. Foods high in antioxidants can also protect against inflammation. Avoid food that is high in saturated or trans-fats. You should also avoid simple refined sugars because they can make inflammation worse.
There are many reasons why you may experience a high ESR and lymphocycte count. Talk to your physician about your specific condition to determine your best diet. You will need a blood test to determine if your levels are high. Although the upper limit for each of these tests varies from doctor to doctor, generally, you have lymphocytosis if you have more than 2,900 lymphocytes in a microliter of blood. Acceptable ESR counts also vary by age and gender.