Reinhart W H
Medizinische Klinik, Inselspital, Bern.
Schweiz Med Wochenschr. 1988 Jun 4;118(22):839-44.
The erythrocyte sedimentation rate is one of the most frequently used laboratory tests in clinical medicine. The sedimentation rate is determined by the aggregation of erythrocytes, in which plasmatic and erythrocytic factors are involved. Plasmatic factors include high-molecular proteins such as fibrinogen, globulins (immunoglobulins, especially IgM, alpha 2-globulins) and immune complexes (e.g. cryoglobulins). Albumin, a smaller protein with a spherical structure, decreases erythrocyte aggregation. Erythrocytic factors play an equally important role. Anemia and macrocytosis lead to an increase in sedimentation rate, whereas the presence of abnormal red cell shapes and deformability decrease the sedimentation rate. The diversity of factors involved often renders the interpretation of sedimentation rates difficult. Normal values for females are higher than for males and increase with age. The sedimentation rate is not useful for screening of asymptomatic subjects, e.g. the detection or exclusion of a malignant tumor. It is appropriate in monitoring the course of diseases such as arteritis temporalis or polymyalgia rheumatica. The sedimentation rate should therefore be used in a more restrictive and selective manner.
红细胞沉降率是临床医学中最常用的实验室检查之一。沉降率由红细胞聚集决定，其中涉及血浆和红细胞因素。血浆因素包括高分子蛋白质，如纤维蛋白原、球蛋白（免疫球蛋白，尤其是IgM、α2球蛋白）和免疫复合物（如冷球蛋白）。白蛋白是一种具有球形结构的较小蛋白质，可减少红细胞聚集。红细胞因素也起着同样重要的作用。贫血和大细胞性贫血会导致沉降率增加，而异常红细胞形状和可变形性的存在则会降低沉降率。所涉及因素的多样性常常使沉降率的解读变得困难。女性的正常数值高于男性，且随年龄增长而增加。沉降率对于筛查无症状受试者并无用处，例如检测或排除恶性肿瘤。它适用于监测颞动脉炎或风湿性多肌痛等疾病的病程。因此，沉降率的使用应更加严格和有选择性。
