Title Sedimentacija eritrocita i C-reaktivni protein: analitička osjetljivost i dijagnostička primjena
Title (english) ERYTHROCYTE SEDIMENTATION RATE AND C REACTIVE PROTEIN : ANALYTICAL SENSITIVITY AND DIAGNSOTIC USE
Author Denis Jagečić
Mentor Ilza Salamunić (mentor)
Committee member Esma Čečuk-Jeličić (predsjednik povjerenstva)
Committee member Ivana Franić (član povjerenstva)
Committee member Ilza Salamunić (član povjerenstva)
Granter University of Split (University Department of Health Studies) Split
Defense date and country 2015-07-24, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Clinical Biochemistry
Abstract Sedimentacija eritrocita (SE) i C reaktivni protein (CRP) su jednostavne, brze i neinvazivne laboratorijske pretrage, primjenjuju se za otkrivanje ili praćenje bolesnika sa sumnjom na upalnu bolest. Odabir SE ili CRP-a u procesu obrade i/ili liječenja bolesnika ovisi o dijagnostičkoj vrijednosti pretrage za određeno stanje ili bolest.
SE je jedna od najstarijih laboratorijskih pretraga, kod koje brzina sedimentiranja ovisi o obliku i broju eritrocita te sastavu plazme. SE je povišena u nekim fiziološkim stanjima kao u trudnoći, a u brojnim patološkim stanjima povezana je najčešće s upalom, anemijom, paraproteinemijom, povećanom koncentracijom fibrinogena, prisustvom hladnih aglutinina.
Referentni raspon za SE varira ovisano o dobi i spolu a kreće se od 15 mm/h do 49 mm/h.
Eritrociti se u normalnim uvjetima međusobno odbijaju. Sijalinska kiselina se nalazi na membrani eritrocita i štiti stanice od ubrzane agregacije. U upalnim stanjima se pojačano sintetiziraju proteini akutnog odgovora organizma, fibrinogen ili imunoglobulini. Te bjelančevine inhibiraju zaštitno djelovanje sijalinske kiseline na površini eritrocita, pa oni brže sedimentiraju.
Za određivanje brzine sedimentacije eritrocita Internacionalni odbor za standardizaciju u hematologiji (engl. International Council for Standardisation in Haematology, ICSH) preporučujeje metodu po Westergreenu, kojom se mjeri brzina taloženja eritrocita u standardiziranoj graduiranoj pipeti u određenom vremenu (1 sat) na sobnoj temperaturi.
Posljednjih su se godina razvile nove, automatizirane metode od kojih su neke modifikacija klasične Westergreenove metode. Većina metoda za automatizirano određivanje sedimentacije koristi analizatore koji primjenjuju mikrofotometar sa infracrvenom zrakom za određivanje optičke gustoće uzorka. Metode su jednostavne i brze, ali nisu standardizirane.
CRP je najznačajniji biljeg akutnoga upalnoga odgovora, osjetljiviji je od SE, u dobroj je korelaciji s težinom i opsegom upale.
Unatoč mišljenju da promjene vrijednosti SE i CRP u podlozi imaju sličnu patofiziološku osnovu, poznate su razlike za istu bolest u vrijednostima među ova dva analita.
Među proteinima akutne faze koji se u laboratoriju mogu jednostavno mjeriti CRP-je jedan od osjetljivijih testova sa brzim odgovorom. SE nije specifična za odgovor akutne faze upale i na nju utječe hematokrit, oblik i veličina eritrocita ...
Preporučene metode za određivanje CRP-a su neobilježene ili izravne tehnike, npr.imunonefelometrija, imunoturbidimetrija i radijalna imunodifuzija
U laboratorijskoj dijagnostici poznavanje značajki metoda za određivanje SE i CRP podrazumijeva , odabir prikladnog uzorka i metode, poznavanje ograničenja metode.
Abstract (english) Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are simple, fast and non-invasive laboratory tests, and are used for the detection or monitoring of patients with suspected inflammatory disease. Selection of ESR or CRP in the processing and / or treatment of a patient depends on the diagnostic value of the test for a given condition or disease.
ESR is one of the oldest laboratory tests, in which the speed of the sedimentation depends on the shape and the number of red blood cells and plasma composition. ESR is elevated in some physiological states as in pregnancy, and in a number of pathological conditions it is associated with inflammation, anemia, paraproteinemia, increased concentration of fibrinogen, presence of cold agglutinins.
The reference range for ESR varies dependent on age and sex and ranges from • 15 mm / h to • 49 mm / h.
The red blood cells in normal conditions repel one another. Sialic acid is on the erythrocyte membrane and protects the cells of accelerated aggregation. In inflammatory conditions proteins of acute response are increasingly synthesized, fibrinogen or immunoglobulins. These proteins inhibit the protective effect of sialic acid on the surface of red blood cells, so they quickly settle down.
To determine the erythrocyte sedimentation speed International Council for Standardization in Haematology (ICSH) recommends a method by Westergren, which measures the speed of sedimentation of erythrocytes in a standardized graduated pipette in a given time (1 hour) at room temperature.
In recent years new, automated methods were developed of which some are modifications of classical Westergren method. Most methods for automated determination of sedimentation uses analyzers to apply microphotometer with infrared ray to determine the optical density of the sample. The methods are simple and fast, but they are not standardized.
CRP is the most important marker of acute inflammatory response, it is more sensitive than ESR, and it is in good correlation with the severity and extent of inflammation.
Despite the opinion that the value changes of ESR and CRP have similar pathophysiological basis in the background, there are differences in values between the two analytes for the same disease
Among the acute phase proteins that can easily be measured in the laboratory, CRP is one of the more sensitive tests with fast response. ESR is not specific for the acute phase inflammatory response and is affected by hematocrit, red cell size and shape
Recommended methods for the determination of CRP are unmarked or direct techniques, npr. immunonephelometry, immunoturbidimetry and radial immunodiffusion.
In the laboratory diagnostics knowledge of the features of methods for determining the SE and CPR means a selection of a suitable sample and method, and the knowledge of the limitations of the method.
Keywords
Sedimentacija eritrocita (SE)
C reaktivni protein (CRP)
eritrociti
Westergren metoda
akutni upalni odgovor
izravne ili neobilježene metode
hematokrit
automatizirane metode
osjetljivost i dijagnostička primjena
Keywords (english)
Erythrocyte sedimentation rate (ESR)
C-reactive protein (CRP)
Erythrocyte
Westergren method
acute phase inflammatory response
unmarked or direct techniques
hematocrit
automated techniques
analytical sensitivity and diagnostic use
Language croatian
URN:NBN urn:nbn:hr:176:481778
Study programme Title: Medical Laboratory Diagnostics (university/undergraduate) Study programme type: university Study level: undergraduate Academic / professional title: sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) medicinska laboratorijska dijagnostika (sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) medicinska laboratorijska dijagnostika)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2020-05-05 06:59:38