Perbandingan Profil Hematologi dan Trombopoietin sebagai Petanda Sepsis Neonatorum Awitan Dini

Abstract

Latar belakang. Sepsis neonatorum memiliki gejala klinis yang tidak spesifik dan diagnosis dengan pemeriksaan kultur memerlukan waktu yang lama. Telah dilaporkan derajat sepsis bertambah seiring peningkatan kadar trombopoietin (TPO) sehingga TPO dapat dijadikan salah satu petanda derajat sepsis. Tujuan. Membandingkan profil hematologi dengan TPO sebagai petanda sepsis neonatorum awitan dini (SNAD). Metode. Studi potong lintang, dilakukan di Sub Bagian Neonatologi Bagian Ilmu Kesehatan Anak RSUP.Prof.Dr.R.D.Kandou, bulan November 2012 sampai April 2014. Didapatkan 103 neonatus tersangka SNAD. Diperbandingkan kadar profil hematologi (jumlah leukosit, jumlah trombosit dan IT rasio) dengan TPO. Hasil. Hasil uji diagnostik TPO dengan cut-off point 259 pg/mL pada SNAD diperoleh nilai sensitivitas 76,8% dan spesifisitas 24,4%; jumlah trombosit (T) sensitivitas 42,9% dan spesifisitas 87,2%; jumlah leukosit (L) sensitivitas 30,4% dan spesifisitas 87,3%; ITrasio (IT) sensitivitas 67,3% dan spesifisitas 50%; L+T diperoleh sensitivitas 58,9% dan spesifisitas 74,5%; L+IT sensitivitas 73,2% dan spesifisitas 46,8%; T+IT sensitivitas 78,6% dan spesifisitas 44,7% sedangkan L+T+IT sensitivitas 83,9% dan spesifisitas 34%. Kesimpulan. Sensitivitas dan spesifisitas TPO tidak lebih tinggi dibandingkan dengan profil hematologi sebagai petanda diagnosis SNAD. Sari Pediatri 2017;18(6):481-6Kata kunci: Jumlah trombosit, jumlah leukosit, IT-rasio, trombopoietin, tersangka sepsis, sepsis neonatorum awitan dini A Comparison of Hematology Profile and Thrombopoietin for Diagnosing Early-Onset Neonatal SepsisRocky Wilar, Silfy Welly, Nurhayati Masloman, Suryadi Tatura Background. Neonatal sepsis has not spesific clinical symptoms and diagnosing with blood culture takes a long time. It had been reported the severity of sepsis increased with increasing levels of thrombopoietin (TPO), that TPO can be used as a marker of the degree of sepsis. Objective. To compare the sensitivity and specificity of hematological profile and TPO for diagnosing early onset neonatal sepsis (EONS). Method. A cross-sectional study, was conducted in the Neonatology division Prof.Dr.R.D.Kandou general hospital from November 2012 to April 2014. There were 103 newborns with suspected EONS who fulfilled the inclusion criteria. Hematology profile (leukocyte-count, platelet-count and IT-ratio) and TPO measurements were performed. Results. TPO with the cut-off point of 259 pg/mL in EONS, obtained sensitivity 76.8% and specificity 24.4%. Sensitivity of Leukocytes (L) 30.4% and specificity 87.3%; sensitivity of platelet-count (T) 42.9% and specificity 87.2%; sensitivity of IT-ratio (IT) 67.3% and specificity 50%; L+T obtained sensitivity of 58.9% and specificity 74.5%; L+IT obtained sensitivity 73.2% and specificity 46.8%; T+IT obtained sensitivity 78.6% and specificity 44.7%, while L+T+IT obtained sensitivity 83.9% and specificity 34%. Conclusion. TPO has not higher sensitivity and spesificity than the hematological profile for early diagnosis of EONS. Sari Pediatri 2017;18(6):