Ramsay Elaine S, Lerman Melissa A
Department of Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Arch Dis Child Educ Pract Ed. 2015 Feb;100(1):30-6. doi: 10.1136/archdischild-2013-305349. Epub 2014 Sep 9.
The erythrocyte sedimentation rate (ESR) has become a ubiquitously used technique in medicine as a marker of systemic illness. The test involves placing anticoagulated whole blood into an upright test tube and monitoring the rate at which red blood cells (RBC) fall over time. Negative charges keep RBC from sticking together. If this charge is neutralised, RBC stack into chains, or rouleaux, and fall more rapidly. ESR can be measured with a variety of tests: Westergren and modified Westergren; Wintrobe; micro-ESR. The Westergren is the most commonly used method of performing the ESR. Technical factors, such as temperature, time from specimen collection, tube orientation and vibration, can affect the results. RBC size, shape and concentration impact the ESR. Plasma characteristics are also important determinants of the ESR. Other factors that can change ESR include age, sex, race, medications and disease states, such as obesity, hypofibrinogenaemia and congestive heart failure. Other acute-phase reactants besides the ESR include C-reactive protein, fibrinogen, complement, ferritin, plasma viscosity, serum amyloid A and albumin. When clinical suspicion for infection or inflammation is low, a normal ESR can reassure that there is no active disease. The slow rise (48 h) and fall of the ESR relative to other acute-phase reactants may make it superior for monitoring inflammation in more chronic conditions. In conjunction with physical findings and other laboratory values, the ESR value can be used to screen for disease or disease complications, aid in disease diagnosis or assess disease activity or response to therapy.
红细胞沉降率（ESR）已成为医学中广泛使用的一项技术，作为全身性疾病的一个标志物。该检测方法是将抗凝全血放入直立的试管中，并监测红细胞（RBC）随时间下降的速率。负电荷可防止红细胞黏附在一起。如果这种电荷被中和，红细胞就会堆叠成链状，即缗钱状，并更快地沉降。ESR可以通过多种检测方法来测量：魏氏法和改良魏氏法；温氏法；微量ESR。魏氏法是最常用的ESR检测方法。技术因素，如温度、标本采集后的时间、试管方向和振动，都会影响检测结果。红细胞的大小、形状和浓度会影响ESR。血浆特性也是ESR的重要决定因素。其他可能改变ESR的因素包括年龄、性别、种族、药物和疾病状态，如肥胖、低纤维蛋白原血症和充血性心力衰竭。除ESR外的其他急性期反应物还包括C反应蛋白、纤维蛋白原、补体、铁蛋白、血浆黏度、血清淀粉样蛋白A和白蛋白。当临床怀疑感染或炎症的可能性较低时，ESR正常可让人放心没有活动性疾病。相对于其他急性期反应物，ESR上升（48小时）和下降缓慢，这可能使其在监测更慢性疾病的炎症方面更具优势。结合体格检查结果和其他实验室值，ESR值可用于筛查疾病或疾病并发症、辅助疾病诊断或评估疾病活动度或对治疗的反应。
