Kadar Antioksidan Rendah Meningkatkan Risiko Hemolisis pada Sepsis Neonatus

Authors

  • Kamilah Budhi Departemen Pediatri Fakultas Kedokteran Universitas Diponegoro/Rumah Sakit Umum Pusat Dr. Kariadi Semarang
  • Agustinus Soemantri Departemen Pediatri Fakultas Kedokteran Universitas Diponegoro/Rumah Sakit Umum Pusat Dr. Kariadi Semarang
  • Asril Aminullah Departemen Pediatri Fakultas Kedokteran Universitas Indonesia/Rumah Sakit Dr . Ciptomangunkusuma Jakarta
  • Suhartono Suhartono Fakultas Kesehatan Masyarakat Universitas Diponegoro Semarang

DOI:

https://doi.org/10.21776/ub.jkb.2011.026.03.10

Abstract

Hemolisis  pada  neonatus  sepsis  terjadi  akibat  aktivasi  komplemen  yang  dipicu  oleh  reaksi  inflamasi  sebagai  respons terhadap  invasi  mikroba.  Penyebab  lain  meliputi:  proses    fisiologis,  kelainan  eritrosit  kongenital,  proses  imun,  stres oksidatif ,  obat  dan  enzim  hemolisin.  Penelitian  ini  bertujuan  untuk  membuktikan  hubungan  antara  kadar  antioksidan dengan kejadian hemolisis pada neonatus  sepsis. Penelitian dilakukan dengan desain observasional prospektif ,  nested case-control  pada  94  neonatus  sepsis  yang  terdiri  47  kelompok  kasus  (hemolisis  positif)  dan  47  kelompok  kontrol (hemolisis negatif). Hemolisis ditegakkan dengan kriteria indeks retikulosit > 3 pada hari ke 1 dan hari ke 3. Variabel yang diukur  meliputi: antioksidan  (GPx,  vitamin  E,  vitamin  C)  dan  oksidan  (MDA),  hemolisin.  Pemeriksaan  kadar  MDA,  GPx dengan  metode  spektrofotometri,  vitamin  C    metode  colorimetric  assay,  vitamin  E  metode  ELISA,  hemolisin  dengan media  agar  darah.  Data  dianalisis  dengan  Chi-square,  uji  t  tidak  berpasangan,  Mantel-Haenszel  dilanjutkan    regresi logistik. Hasil penelitian menunjukkan kadar GPx rendah (75µ/gHb), vitamin E rendah ((<17,8 µg/mL) merupakan faktor risiko signifikan terjadinya hemolisis dengan OR berturut-turut 6,14 ,  3,12. Kadar antioksidan rendah (GPx  dan vitamin E) merupakan  prediktor  kuat  terjadinya  hemolisis  pada  neonatus  sepsis.

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References

Haque KN. Definition of Blood Stream Infection in the Newborn. Pediatric Critical Care Medicine. 2005; 6(3): 45-49.

Alamsyah E. Analisis Epidemiologi Upaya Kesehatan Maternal Neonatal di Indonesia dalam PencapaianTarget Millenium Development Goals (MDGs) 2015. Perinasia. 2010; 1: 1-4.

Dalle-Donne I, Rossi R, Colombo R, Gustarini D, and Milzano A. Biomarkers of Oxidative Damage in Human Disease. Clinical Chemistry. 2006; 52(4): 601-623.

Bender DA. Micronutrients: Vitamins & Minerals. In: Harper (Ed). Illustrated Biochemistry 28th edition. Philadelphia: McGraw Hill; 2009; p. 467-481.

Mohan SK and Priya V. Status of Lipid Peroxidation, Glutathione, Ascorbic Acid, Vitamin E and Antioxidant Enzymes in Neonatal Jaundice Patients. Journal of Clinical and Diagnostic Research. 2008; 3: 827-832.

Wilson JX. Mechanism of Action of Vitamin C in Sepsis: Ascorbate Modulates Redox Signaling in Endothelium. International Union of Biochemistry and Molecular Biology. 2009; 35(1): 5-13.

Karim R and Mannan MA. α-Tocopherol Reduces Oxidative Stress in Perinatal Asphyxia. Bangladesh Journal of Pharmacol. 2006; 1: 5-9.

Gill H and Walker G. Selenium: Immune Function and Resistence to Viral Infections. Nutrition & Dietetics. 2008; 65(3): 41-47.

Segel GB. Hemolytic Anemia. In: Kliegman RM (Ed). Nelson Text Book of Pediatrics 19th edition. Philadelphia: Saunders; 2011; p. 1659-1682.

Ambalavanan N dan Carlo WA. Jaundice and Hyperbilirubinemia in the Newborn. In: Kliegman RM (Ed). Nelson Textbook of Pediatrics 19 edition. Philadelphia: Saunders; 2011; p. 603-612.

Gomella TL. Hyperbilirubinemia Indirect (Unconjugated Hyperbilirubinemia). In: Gomella TL (Ed). Neonatology 6th edition. New York: Mc Graw Hill; 2009; p. 293-301.

Lewis DB dan Wilson CB. Developmental Immunology and Role of Host Defenses in Fetal and Neonatal Susceptibility to Infection. In: Remington JS, Klein JO, Wilson CB, Nizet V, dan Maldonado Y A (Ed). Infectious Diseases of the Fetus and Newborn Infant 7th edition. Philadelphia: Saunders; 2011; p. 81-172.

Murphy K, Travers P, dan Walport M. Allergy and Hypersensitivity. In: Janeway(Ed). Immunobiology7th edition. New York: Garland Science; 2008; hal. 555-590.

Bauman R. Innate Immunity. In: Bauman R (Ed). Microbiology with Diseases by Taxonomy 2nd edition. New York: Pearson; 2007; p. 437-457.

Budhi K. Kejadian Hemolisis pada Neonatus Sepsis di PBRT RSDK Tahun 2006. Penelitian Pendahuluan. Unpublished.

Gordis L. Case Control and Cross-Sectional Studies. Baltimore: Saunders; 2009; p. 56-140.

Budhi K. Harga Normal Kadar MDA, GPx, Vitamin C, Vitamin E dan Hematokrit pada Bayi Sehat Bangsa Indonesia. Penelitian Pendahuluan. Unpublished.

Altman DG. Practical Statistics for Medical Research. Edisi 1. London: Chapman Hall; 1991.

Downson B dan Robert G. Research Questions About Two Separate or Independents Groups.In: Downson B, dan Robert G (Ed). Trapp Basic & Clinical Biostatistics Edisi 4. Boston: McGraw Hill; 2004; p. 134-158.

Razzak KK, Nusier MK, Obediat AD, and Salim AM. Antioxidant Vitamins and Hyperbilirubinemia in Neonates. German Medical Science. 2007; 5: Doc03

Strachan S and Wyncoll D. Selenium in Critically Ill Patients. The Intensive Care Society. 2009; 10(1): 38-43.

Kapoor K, Basu S, Das BK, and Bhatia BD. Lipid Peroxidation and Antioxidants in Neonatal Septicemia. Journal of Tropical Pediatrics. 2006; 52(5): 372-375.

Nielsen F, Mikkelsen BB, Nielseb JB, Andersen HR, and Grandjean P. Plasma Malondialdehyde as Biomarker Oxidative Stress: Reference Interval and Effects of Life Style Factors. Clinical Chemistry. 1997; 43(7): 1209-1214.

Donald J, Galley HF, and Webster NR. Oxidative Stress and Gene Expression in Sepsis. British Journal of Anaesthesia. 2003; 90(2): 221-232.

Yiqit S, Yurdakok M, Kilinc K, Oran O, Erdem G, and Tekinalp G. Serum Malondialdehyde Concentration as a Measure of Oxygen Free Radical Damage in Preterm Infants. The Turkish Journal of Pediatrics. 1998; 40(2): 177-183.

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Published

2013-04-27

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Research Article

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