Introduction. The clinical value of erythrocyte sedimentation rate (ESR) is often underestimated, which underlines the importance of our investigation.
Purpose. With the aim of estimation of ESR clinical value we held a literature review in Pubmed database and Ukrainian sources.
Materials and methods. We analyzed own data of 315 patients (98 with ischemic heart disease (IHD) who underwent coronary bypass grafting (CBG); 142 with IHD (myocardial infarction) who were treated by drugs only; 75 with hemorrhagic vasculitis (HV) who were divided into groups according to gallbladder (GB) condition. The obtained data was processed by using Spearman’s and Pearson’s coefficients.
Results. ESR phenomenon was noticed in 1897 by E.F. Biernacki. In 1921 A.V.A. Westergren set a standard method of its analysis. ESR is influenced by many factors including fibrinogen and immunoglobulines levels, the quantity and quality of erythrocytes, plasma proteins, age, sex, race, etc.). ESR is a predictor of mortality from IHD in healthy middle-aged men. According to own data, the value of ESR was the highest in patients with HV. GB condition also influenced ESR, which was maximal in case of GB neck deformations, cholecystitis, cholelithiasis, cholecystectomy (CE) in anamnesis. In patients with HV the increase of ESR was associated with the increase of C-reactive protein (CRP) (r = 0.53), the decrease of erythrocytes (r = - 0.57), hemoglobin (r = - 0.53) and bilirubin (r = - 0.38), right ventricle enlargement (r = 0.58). In case of sludge in patients with HV ESR was associated with age (r = 0.71), inflammation activity, right ventricle size (r = 0.78). In patients with IHD a significant correlation of ESR was found in cases preparing for CBG: with white blood cells (r = 0.61), beta-lipoproteids (r = 0.69), heart rate (r = 0.56). In case of a bent GB body significant correlations were revealed only in people who received a conservative treatment. GB neck deformations and cholecystitis were characterized by significant correlations of ESR and CRP in patients with HV (r = 0.91) and with fibrinogen in patients before CBG (r = 0.41). In case of cholelithiasis, patients with HV had a correlation of ESR with de Ritis coefficient (r = - 0.78). In patients who underwent a conservative treatment, the increase of ESR was correlated with anemia. CE in anamnesis was characterized by high levels of ESR in patients with HV and IHD who underwent a conservative treatment. In patients preparing for CBG CE was associated with glycemic level (r = 0,93).
Conclusions. ESR is higher during inflammatory diseases; GB condition influences inflammation activity; correlations of ESR were dependent from pathology and GB condition; ESR is more often correlated with parameters of inflammation, anemia severity, lipid and glucose metabolism, structural heart parameters.
Article recieved: 03.07.2018
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