KESESUAIAN ANTARA KADAR CRP TERHADAP JUM.LAII NEUTROFIL DAN KADAR FERITIN SERUM PADA WANITA HAMIL TRIMESTER KEDUA

Abstract

Backgrounds: Iron deficiency is considered as the most dominant cause of anemia in pregnant women. Serum ferritin level in iron deficiency may reflect iron storage in the body and will first decrease than the other parameters. The existence of inflammation may confuse interpretation in ferritin level. CRP positive and neutrophilia are inflammation response condition. Serum ferritin level can show an increase when iron deficiency and inflammation coexist. Objective: The aimed of this study was to explain the appropriation between CRP level in neutrophils count, and serum ferritin level in pregnant women the second trimester. Methods: The design of this study was appropriation test (kappa) using the cross sectional approach. The sample consists of 67 pregnant women in the second trimester taken as study' s subjects for measurements of Hb level, serum ferritin, CRP, and neutrophils count. Hb level < 11 g/dl is categorized anemia, whereas ferritin level < 20 gg/L is classified as iron deficiency. CRP is classified as positive when it turns into 6 mg/L and mean while, for neutrophilia is 80 %. Computer software SPSS PC version 10.0. is used to determine the kappa point. Results: The categorized anemia was 34 women (64,2%) with the mean of Hb level 10.22 g/dl (SD = 0.76) and 35 women (52,2%) was classified as iron deficiency with the mean of ferritin level 11,85 gg/L (SD = 4,79). CRP positive with neutrophilia was found in two women, whereas for CRP positive with ferritin level 20 gg/L were found in nine women. The appropriation test of CRP and neutrophils count, showed kappa point of 0.2, p = 0,024, indicating a low approprition. The difference was caused by neutrophils count influenced by hemodilution, life span of neutrophils count in circulation (4 — 8 hours), and precence of neutrophils within the injured tissue by development of inflammation. From the appropriation test between CRP towards ferritin level, it was found that kappa point was 0.2,p = 0.037 which means that there is a low appropiation. Conclution: Analytically, there were weak appropriation between CRP with neutrophils count as well as serum ferritin level. Latar Belakang : Defisiensi besi dianggap sebagai penyebab yang paling dominan pada anemia wanita hamil Pemeriksaan feritin serum pada defisiensi besi dapat mencerminkan simpanan besi tubuh. Kadamya akan menurun paling dini terhadap parameter yang lain Adanya peradangan dapat mengacaukan interpretasi pada pemeriksaan feritin. CRP positip dan Neutrofilia sebagai respon atas adanya peradangan. Kadar feritin serum dapat meningkat apabila defisiensi besi bersamaan dengan peradangan. Tujuan : Menjelaskan kesesuaian antara kadar CRP terhadap jumlah neutrofil dan kadar feritin serum pada wanita hamil. Metode Penelitian : Jenis penelitian adalah uji kesesuaian (kappa) dengan pendekatan belah lintang. Sampel sejumlah 67 orang wanita hamil trimester kedua diambil sebagai subyek penelitian kemudian diukur kadar fib, feritin serum, CRP dan jumlah neutrofil. Status Fib dikatagorikan anemia bila Fib < 11 g/dl dan status feritin dikatagorikan defisiensi besi bila feritin < 20 gg/L. Status CRP dikatagorikan positip bila ~. 6 mg/L dan jumlah neutrofilia dikatagorikan neutrofilia bila 80%. Untuk menentukan nilai kappa, menggunakan perangkat lunak komputer SPSS PC versi 10.0. Hasil : Empat puluh tiga orang (64,2%) menderita anemia dengan rerata kadar Hb 10,22 g/dl (SB=0,76) dan 35 orang (52,2%) mengalami defisiensi besi dengan rerarta kadar feritin serum 11,85 utg/L (513=4,79). CRP positip dengan neutirofilia adalah 2 orang sedangkan CRP positip dengan kadar feritin ~- 20 ug/L adalah 9 orang. Hasil uji kesesuaian antara CRP terhadap jumlah neutrofil didapatkan nilai kappa = 0,2 , p = 0,024 yang berarti terdapat kesesuain yang lemah. Perbedaan ini disebabkan jumlah neutrofil dapat dipengaruhi oleh hemodilusi, masa hidup di sirkulasi 4-8 jam dan neutrofil dikerahkan menuju jaringan yang rusak akibat perjalanan inflamasi. Hasil uji kesesuaian antara CRP terhadap kadar feritin, didapatkan nilai kappa = 0,2 , p = 0,037, yang berarti terdapat kesesuaian yang lemah. Hal ini tergantung dari kondisi awal kadar feritin serum pada wanita hamil Kesimpulan : Secara statistik terdapat kesesuaian yang lemah antara CRP terhadap jumlah neutrofil dan kadar feritin serum