{"id":193,"date":"2025-06-11T11:46:00","date_gmt":"2025-06-11T11:46:00","guid":{"rendered":"https:\/\/analizesanocare.ro\/?post_type=product&#038;p=193"},"modified":"2025-08-08T13:58:12","modified_gmt":"2025-08-08T13:58:12","slug":"viteza-de-sedimentare-a-hematiilor-vsh","status":"publish","type":"product","link":"https:\/\/analizesanocare.ro\/en\/analiz\u0103\/viteza-de-sedimentare-a-hematiilor-vsh\/","title":{"rendered":"Viteza de sedimentare a hematiilor (VSH)"},"content":{"rendered":"<div class=\"info-content content-informatii-generale\">\n<h2><strong>Informa\u0163ii generale Viteza de sedimentare a hematiilor (VSH) <\/strong><\/h2>\n<p>Sedimentarea hematiilor apare atunci c\u00e2nd eritrocitele agreg\u0103 sub forma unei coloane. In mod normal hematiile dintr-o prob\u0103 de s\u00e2nge sedimenteaz\u0103 lent datorit\u0103 \u00eenc\u0103rc\u0103turii de suprafa\u0163\u0103 negative a acestora, care face ca celulele adiacente s\u0103 se resping\u0103 c\u00e2nd distan\u0163a intercelular\u0103 scade sub un nivel minim. In anumite afec\u0163iuni care determin\u0103 cre\u015fterea proteinelor de faz\u0103 acut\u0103 (\u03b1-globuline, <a href=\"https:\/\/www.synevo.ro\/shop\/fibrinogen\/\" target=\"_blank\" rel=\"noopener\" data-wpel-link=\"internal\">fibrinogen<\/a>) sau imunoglobulinelor, proteinele plasmatice se ata\u015feaz\u0103 pe suprafa\u0163a hematiilor \u015fi reduc poten\u0163ialul de suprafa\u0163\u0103 determin\u00e2nd agregarea hematiilor \u015fi cre\u015fterea sediment\u0103rii acestora<sup>1;2<\/sup>.<\/p>\n<p>VSH-ul reprezint\u0103 rata la care sedimenteaz\u0103 hematiile dintr-o prob\u0103 de s\u00e2nge anticoagulat \u00eentr-o or\u0103. Cu c\u00e2t hematiile sedimenteaz\u0103 mai repede, cu at\u00e2t VSH-ul este mai mare, fiind un indicator de r\u0103spuns de faz\u0103 acut\u0103. O cre\u015ftere a VSH-ului apare la cel pu\u0163in 24 ore dup\u0103 ini\u0163ierea r\u0103spunsului inflamator, iar dup\u0103 \u00eencheierea r\u0103spunsului de faz\u0103 acut\u0103 scade cu un timp de \u00eenjum\u0103t\u0103\u0163ire de 96-144 ore.<\/p>\n<p>In compara\u0163ie cu <a href=\"https:\/\/www.synevo.ro\/shop\/proteina-c-reactiva-crp\/\" target=\"_blank\" rel=\"noopener\" data-wpel-link=\"internal\">CRP<\/a> \u015fi amiloidul A seric, VSH-ul este crescut \u015fi \u00een situa\u0163iile\u00a0\u00een care se produce cre\u015fterea concentra\u0163iei imunoglobulinelor, complexelor imune \u015fi altor proteine<sup>2<\/sup>.<\/p>\n<h2><strong>Indica\u0163ii Viteza de sedimentare a hematiilor (VSH)<\/strong><\/h2>\n<ul>\n<li>Test screening \u00een suspiciunea de reac\u0163ii inflamatorii, infec\u0163ii, <a href=\"https:\/\/www.synevo.ro\/boli-autoimune-cauze-si-diagnostic\/\" data-wpel-link=\"internal\">boli autoimune<\/a>, discrazii plasmocitare.<\/li>\n<li>Monitorizarea evolu\u0163iei \u015fi tratamentului \u00een anumite boli: arterit\u0103 temporal\u0103, polimialgie reumatic\u0103, artrit\u0103 reumatoid\u0103, reumatism articular acut, <a href=\"https:\/\/www.synevo.ro\/lupus-eritematos-sistemic-o-boala-autoimuna\/\" data-wpel-link=\"internal\">lupus eritematos sistemic<\/a>, boala Hodgkin, <a href=\"https:\/\/www.synevo.ro\/ziua-mondiala-a-tuberculozei\/\" data-wpel-link=\"internal\">tuberculoz\u0103<\/a>, endocardit\u0103 bacterian\u0103.<\/li>\n<li>Diagnosticul arteritei temporale, polimialgiei reumatice<sup>3<\/sup>.<\/li>\n<\/ul>\n<p>VSH-ul nu este un test diagnostic pentru o anumit\u0103 boal\u0103 \u015fi nu trebuie utilizat pentru screening-ul pacien\u0163ilor asimptomatici<sup>1<\/sup>.<\/p>\n<h2><strong>Preg\u0103tire pacient<\/strong><\/h2>\n<p>\u00e0 jeun\/ postprandial; o mas\u0103 lipidic\u0103 poate determina alter\u0103ri plasmatice<sup>1;4<\/sup>.<\/p>\n<p><strong>Specimen recoltat<\/strong> \u2013 s\u00e2nge venos<sup>4<\/sup>.<\/p>\n<p><strong>Recipient de recoltare<\/strong> \u2013 vacutainer cu citrat de sodiu 3.8% tamponat sau vacutainer cu EDTA K3 (pentru metoda microfotometric\u0103 capilar\u0103)<sup>4<\/sup>.<\/p>\n<p><strong>Cantitate recoltat\u0103<\/strong> \u2013 c\u00e2t permite vacuumul<sup>4<\/sup>.<\/p>\n<p><strong>Cauze de respingere a probei<\/strong> \u2013 cantitate insuficient\u0103, specimen coagulat, specimen hemolizat<sup>5<\/sup>.<\/p>\n<p><strong>Stabilitate prob\u0103<\/strong><\/p>\n<ul>\n<li>2 ore la temperatura camerei (18-26\u00b0C); testul ar trebui efectuat la cel mult 2 ore dup\u0103 recoltare. Dac\u0103 este ratat\u0103 citirea la 1 or\u0103, s\u00e2ngele nu poate fi remixat \u015fi refolosit pentru VSH. Testul trebuie efectuat la temperatura camerei<sup>4<\/sup>.<\/li>\n<li>12 ore la 2-8\u00b0C; dac\u0103 s\u00e2ngele a fost refrigerat, trebuie reechilibrat la temperatura camerei \u00eenaintea efectu\u0103rii testului<sup>4<\/sup>.<\/li>\n<li>24 ore la 4 \u2013 8 \u00b0 C \u2013 pentru probele recoltate pe K3 EDTA; s\u00e2ngele refrigerat, trebuie reechilibrat la temperatura camerei \u00eenaintea efectu\u0103rii testului<sup>4<\/sup>.<\/li>\n<\/ul>\n<p><strong>Metode<\/strong><\/p>\n<ul>\n<li>metoda manual\u0103 Westergren: se a\u015feaz\u0103 tubul \u00een pozi\u0163ie vertical\u0103 \u00eentr-un suport gradat milimetric \u015fi se cite\u015fte nivelul de sedimentare a hematiilor\u00a0\u00een mm dup\u0103 1 ora;\u00a0\u00een unele teste este citit rezultatul \u015fi dup\u0103 un interval de 2 ore, dar acesta nu furnizeaz\u0103 informa\u0163ii suplimentare<sup>2;4<\/sup>.<\/li>\n<li>metoda automat\u0103 de citire VSH (cu ajutorul unui sistem de raze infraro\u015fii)<sup>4<\/sup>.<\/li>\n<li>metoda microfotometric\u0103 capilar\u0103: m\u0103soar\u0103 capacitatea de\u00a0agregare a eritrocitelor (prima etap\u0103 a sediment\u0103rii) \u00een prezen\u0163a aglomerinelor, la 37\u00b0C<sup>4<\/sup>.<\/li>\n<\/ul>\n<h2><strong>Valori de referin\u0163\u0103 Viteza de sedimentare a hematiilor (VSH)<\/strong><\/h2>\n<p>B\u0103rba\u0163i:\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Femei:<\/p>\n<p>&lt;50 ani: \u00a0\u00a0\u00a0&lt;15 mm\/h\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0&lt;50 ani:\u00a0\u00a0\u00a0\u00a0 &lt;20 mm\/h<\/p>\n<p>50-85 ani: &lt;20 mm\/h\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 50-85 ani: &lt; 30 mm\/h<\/p>\n<p>&gt;85 ani: \u00a0\u00a0\u00a0&lt;30 mm\/h\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0&gt;85 ani: \u00a0\u00a0\u00a0 &lt;42 mm\/h<\/p>\n<p>Copii (0-18 ani): &lt;10 mm\/h<\/p>\n<p>Sarcina (s\u0103pt\u0103m\u00e2nile 1-20): 18-48 mm\/h\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sarcina (s\u0103pt\u0103m\u00e2nile 21-40): 30-70 mm\/h<\/p>\n<p><strong>Semnifica\u0163ie clinic\u0103<\/strong><strong>\u00a0<\/strong><\/p>\n<p>1. VSH crescut<\/p>\n<ul>\n<li>Boli de colagen; este cel mai util test pentru diagnosticul \u015fi monitorizarea arteritei temporale, artritei reumatoide \u015fi polimialgiei reumatice.<\/li>\n<li>Infec\u0163ii, pneumonii, <a href=\"https:\/\/www.synevo.ro\/sifilis-o-boala-cu-transmitere-sexuala\/\" data-wpel-link=\"internal\">sifilis<\/a>, tuberculoz\u0103, endocardit\u0103 bacterian\u0103 subacut\u0103.<\/li>\n<li>Boli inflamatorii: boala inflamatorie pelvin\u0103 acut\u0103, <a href=\"https:\/\/www.synevo.ro\/guta-rezultatul-unei-tulburari-metabolice\/\" data-wpel-link=\"internal\">guta<\/a>, artrita, <a href=\"https:\/\/www.synevo.ro\/nefrita-si-cistita-la-copil\/\" data-wpel-link=\"internal\">nefrita<\/a>, nefroza.<\/li>\n<li>Boli neoplazice.<\/li>\n<li>Cre\u015fterea imunoglobulinelor serice, mielom multiplu, macroglobulinemie Waldenstr\u00f6m.<\/li>\n<li>Intoxica\u0163ii acute cu metale grele.<\/li>\n<li>Distruc\u0163ii tisulare\/celulare, infarct miocardic acut, postoperator (valorile crescute se pot men\u0163ine p\u00e2n\u0103 la 1 lun\u0103).<\/li>\n<li>Toxemie, <a href=\"https:\/\/www.synevo.ro\/hipotiroidism-tulburare-a-functiei-tiroidiene\/\" data-wpel-link=\"internal\">hipotiroidism<\/a>, <a href=\"https:\/\/www.synevo.ro\/hipertiroidism-tulburare-hormonilor-tiroidieni\/\" data-wpel-link=\"internal\">hipertiroidism<\/a>.<\/li>\n<li><a href=\"https:\/\/www.synevo.ro\/ce-este-si-ce-se-ascunde-in-spatele-unei-anemii\/\" data-wpel-link=\"internal\">Anemia<\/a> acut\u0103 sau din bolile cronice.<\/li>\n<\/ul>\n<p>! Un VSH moderat crescut trebuie \u00eentotdeauna investigat<sup>1;3<\/sup>.<\/p>\n<p>2. VSH normal:<\/p>\n<ul>\n<li>Policitemie vera.<\/li>\n<li><a href=\"https:\/\/www.synevo.ro\/anemia-feripriva-cea-mai-frecventa-anemie\/\" data-wpel-link=\"internal\">Anemie feripriv\u0103.<\/a><\/li>\n<li>Infec\u0163ii virale necomplicate, <a href=\"https:\/\/www.synevo.ro\/mononucleoza-infectioasa-numita-si-boala-sarutului\/\" data-wpel-link=\"internal\">mononucleoza infec\u0163ioas\u0103<\/a>.<\/li>\n<li>Insuficien\u0163a cardiac\u0103 congestiv\u0103, boala renal\u0103 activ\u0103 cu insuficien\u0163\u0103 cardiac\u0103.<\/li>\n<li>Alergie acut\u0103.<\/li>\n<li>Ulcer peptic.<\/li>\n<\/ul>\n<p>Un VSH normal nu exclude o boal\u0103 organic\u0103 non-inflamatorie, disfunc\u0163ie de organ\/neoplazie<sup>1;2<\/sup>.<\/p>\n<p><strong>Valori critice <\/strong>\u2013 cre\u015fteri extreme ale VSH apar \u00een limfoame, carcinoame maligne de colon\/s\u00e2n, mielom multiplu \u015fi artrita reumatoid\u0103<sup>1<\/sup>.<\/p>\n<p>VSH &gt;100 mm\/h apare \u00een: metastaze, boli renale (\u00een special cele cu azotemie), infec\u0163ii severe (osteomielit\u0103, endocardit\u0103 bacterian\u0103 subacut\u0103), polimialgie reumatic\u0103<sup>2<\/sup>.<\/p>\n<p><strong>Limite \u015fi interferen\u0163e<\/strong><\/p>\n<p>1. Varia\u0163ii fiziologice:<\/p>\n<ul>\n<li>Menstrua\u0163ia: VSH-ul cre\u015fte \u00een timpul ciclului menstrual, ating\u00e2nd nivelul maxim\u00a0\u00een faza premenstrual\u0103 \u015fi sc\u0103z\u00e2nd\u00a0\u00een timpul menstrua\u0163iei<sup>1<\/sup>.<\/li>\n<li>Sarcina: VSH-ul cre\u015fte continuu \u00eencep\u00e2nd cu a 4-a s\u0103pt\u0103m\u00e2n\u0103 de sarcin\u0103 p\u00e2n\u0103\u00a0\u00een a 3-a s\u0103pt\u0103m\u00e2n\u0103 postpartum<sup>3<\/sup> \u015fi atinge un nivel maxim de p\u00e2n\u0103 la 45 mm\/h \u00een prima s\u0103pt\u0103m\u00e2n\u0103 postpartum<sup>1<\/sup>.<\/li>\n<li>Nou-n\u0103scu\u0163i: VSH-ul este sc\u0103zut datorit\u0103 hematocritului crescut \u015fi nivelului sc\u0103zut de fibrinogen<sup>1<\/sup>.<\/li>\n<li>Femei v\u00e2rstnice (70-89 ani) aparent s\u0103n\u0103toase pot avea un VSH foarte mare (p\u00e2n\u0103 la 60 mm\/h)<sup>1<\/sup>.<\/li>\n<\/ul>\n<p>2. Factori care determin\u0103 VSH crescut:<\/p>\n<ul>\n<li>S\u00e2nge refrigerat<sup>1<\/sup>.<\/li>\n<li>Anemia: datorit\u0103 num\u0103rului sc\u0103zut de eritrocite; \u00een anemia feripriv\u0103 cre\u015fterea VSH nu corespunde num\u0103rului de eritrocite deoarece microcitoza concomitent\u0103 \u00eencetine\u015fte sedimentarea hematiilor.<\/li>\n<li>Macrocitoza.<\/li>\n<li>Medicamente: contraceptive orale, dextrani\u00a0 (datorit\u0103 absorb\u0163iei pe suprafa\u0163a eritrocitelor), anticonvulsivante, aspirina, carbamazepina, cefalotin, ciclosporina A, dexametazona, etretinat, fluvastatin, hidralazina, indometacin, isotretinoin, lomefloxacin, metisergid, misoprostol, ofloxacin, procainamida, propafenona, quinina, sulfametoxazol, zolpidem<sup>1;2<\/sup>.<\/li>\n<\/ul>\n<p>3. Factori care scad VSH-ul:<\/p>\n<ul>\n<li>\n<div>Temperaturi &gt;20-24\u00b0C<sup>2<\/sup>.<\/div>\n<\/li>\n<li>\n<div>\u00a0Hiperglicemia<sup>1<\/sup>.<\/div>\n<\/li>\n<li>\n<div>\u00a0Hiperlipoproteinemia (in special chilomicronii)<sup>2<\/sup>.<\/div>\n<\/li>\n<li>\n<div>\u00a0Hipofibrinogenemia.<\/div>\n<\/li>\n<li>\n<div>\u00a0Policitemia.<\/div>\n<\/li>\n<li>\n<div>\u00a0Hiperleucocitoza<sup>1<\/sup>.<\/div>\n<\/li>\n<li>\n<div>\u00a0Prezen\u0163a de eritrocite anormale: microcite, drepanocite, echinocite, poichilocite, stomatocite, acantocite, sferocite (prin sc\u0103derea suprafe\u0163ei necesare pentru agregarea hematiilor)<sup>4<\/sup>.<\/div>\n<\/li>\n<li>\n<div>\u00a0Casexia<sup>3<\/sup>.<\/div>\n<div>Medicamente: aspirina, aur, corticotropin, ciclofosfamida, glucocorticoizi, hidroxiclorochina, metotrexat, antiinflamatorii nesteroidiene, penicilamina, sulfasalzina, tamoxifen, trimetoprim<sup>1<\/sup>.<\/div>\n<\/li>\n<\/ul>\n<h2><strong>Bibliografie<\/strong><\/h2>\n<ol>\n<li>Fischbach F, Dunning III M. Blood Studies: Hematology and Coagulation. In A Manual of Laboratory and Diagnostic Tests, Philadelphia, 8 Ed, 2009, 110-111, 1237.<\/li>\n<li>Thomas L. Tests for the Diagnosis of Inflammation. In Clinical Laboratory Diagnostics, First Edition, Frankfurt\/Main, 1998, 698-699.<\/li>\n<li>Wallach J. Interpretarea testelor de diagnostic, Ed VII, Trad Ionescu R, Dragomir M, Ed \u015etiin\u0163elor Medicale, Buc, 115-117.<\/li>\n<li>Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate. 2015. Ref Type: Catalog<\/li>\n<li>DeMott W, Tilzer L. Hematology. In Laboratory Test Handbook, 3<sup>rd<\/sup> Edition, Hudson (Cleveland), 1994, 599-600.<\/li>\n<li>Chernecky CC, Berger JB. Laboratory Tests and Diagnostic Procedures. Sixth Edition, 2013. Elsevier Saunders.<\/li>\n<\/ol>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Informa\u0163ii generale Viteza de sedimentare a hematiilor (VSH) Sedimentarea hematiilor apare atunci c\u00e2nd eritrocitele agreg\u0103 sub forma unei coloane. In mod normal hematiile dintr-o prob\u0103 de s\u00e2nge sedimenteaz\u0103 lent datorit\u0103 \u00eenc\u0103rc\u0103turii de suprafa\u0163\u0103 negative a acestora, care face ca celulele adiacente s\u0103 se resping\u0103 c\u00e2nd distan\u0163a intercelular\u0103 scade sub un nivel minim. In anumite afec\u0163iuni [&hellip;]<\/p>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false},"product_brand":[],"product_cat":[53,34],"product_tag":[],"class_list":["post-193","product","type-product","status-publish","product_cat-morfofiziologie","product_cat-teste-de-hematologie","first","instock","shipping-taxable","purchasable","product-type-simple"],"acf":[],"_links":{"self":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product\/193","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/types\/product"}],"wp:attachment":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/media?parent=193"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_brand?post=193"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_cat?post=193"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_tag?post=193"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}