Kirkeby O J, Risøe C, Vikland R
Br J Clin Pract. 1989 Jul;43(7):252-4.
For eight months the erythrocyte sedimentation rate (ESR) was recorded prospectively in patients over 70 years of age to elucidate the prevalence and causes of high ESR in this age group. All patients having an ESR over 40 mm/h were thoroughly investigated. Ninety men and 349 women had their ESR taken. Sixteen men (18 per cent) and 42 women (12 per cent) had an ESR above this level. Eighty-four separate diagnoses were found to contribute to an elevation of the ESR. Twenty-eight patients (40 per cent of those with high ESR) had multiple diagnoses that might have contributed to the high ESR. The most frequent diagnoses were infection, especially chronic bronchitis, rheumatoid arthritis and renal failure. As a result of the study, nine new diagnoses were found and three patients could be offered effective treatment. We conclude that a multifactorial aetiology is common when the ESR is elevated and that a thorough examination is advisable in such cases. However, screening of ESR in elderly patients in general practice has little therapeutic consequence and selective use of the test is preferable.
对70岁以上的患者前瞻性地记录了8个月的红细胞沉降率（ESR），以阐明该年龄组ESR升高的患病率和原因。对所有ESR超过40mm/h的患者进行了全面调查。90名男性和349名女性进行了ESR检测。16名男性（18%）和42名女性（12%）的ESR高于此水平。发现84种不同的诊断导致ESR升高。28名患者（ESR升高患者中的40%）有多种可能导致ESR升高的诊断。最常见的诊断是感染，尤其是慢性支气管炎、类风湿性关节炎和肾衰竭。研究结果发现了9种新诊断，3名患者可以接受有效治疗。我们得出结论，ESR升高时多因素病因很常见，在这种情况下建议进行全面检查。然而，在全科医疗中对老年患者进行ESR筛查几乎没有治疗意义，选择性使用该检测方法更可取。
