HUBUNGAN ANTARA HEMOGLOBIN PRA DAN PASCA TRANSFUSI SERTA KADAR FERRITIN DENGAN PERTUMBUHAN PADA ANAK PENDERITA THALASSEMIA MAYOR PENERIMA PROGRAM TERAPI TRANSFUSI DARAH DAN KELATOR BESI

GUNTUR MARGANING ADI NUGROHO, Dr. dr. Sri Mulatsih, Sp.A(K); dr. Madarina Julia, MPH, Ph.D, Sp.A(K)

2015 | Skripsi | PENDIDIKAN DOKTER

Hambatan pertumbuhan berupa stunting pada anak thalassemia mayor merupakan salah satu komplikasi tersering pada penyakit thalassemia pada anak-anak. Hambatan ini diduga berhubungan dengan kadar nilai Hb pra dan pasca transfusi serta kadar ferritin melalui kondisi hemosiderosis dan eritropoesis yang tidak efektif. Tujuan : Mengetahui hubungan antara hemoglobin pra dan pasca serta kadar ferritin pertama dan rata-rata dengan kondisi keterlambatan pertumbuhan pada penyandang thalassemia mayor penerima program transfusi darah dan kelasi besi di RSUP Dr. Sardjito. Metode : Studi potong lintang. Subyek penelitian adalah anak thalassemia mayor usia 3-18 tahun. Pengukuran anthropometri menggunakan stadiometer, penimbang badan, dan pita ukur. Data tentang riwayat transfusi dan kadar ferritin dilihat dari buku harian penyandang thalassemia. Hasil : Lima puluh tiga anak diteliti. Anak dengan tinggi badan normal (>-2 SD) 54,7%, anak pendek (-2 sampai dengan -3 SD) 34%, dan anak sangat pendek (<3 SD) 11,3%. Rerata Hb pratransfusi 7,66(±0,89) g/dl, Hb pascatransfusi 12,41(±0,75) g/dl, dan kadar ferritin 3.034,06 (±1.862,27) µg/l. Terdapat korelasi antara Hb pascatransfusi dengan nilai HAZ (r = 0,37 p = 0,02), namun tidak ada korelasi bermakna antara nilai HAZ dengan Hb pratransfusi (r= 0,13 p = 0,42) dan kadar ferritin (r = -0,01 p = 0,97). Simpulan : Tingginya nilai Hb pascatransfusi berkorasi dengan tingginya nilai HAZ pada anak thalassemia mayor.

Growth retardation or stunting is one of most common complication in thalassemia major children. Hypothetically it is connected Hb pratransfussion, Hb posttransfusion, and ferritin level via hemosiderosis and ineffective erithropoesis. Objective : To determine the correlation between Hb pratransfuison, Hb posttransfusion, and ferritin level with HAZ score in thalassemia major children. Methods : Cross-sectional design. Subjects were children with thalassemia major aged 3-18 years old. Anthropometry measurements performed with stadiometer, body weight scale, and measuring tape. History of transfusions and ferritin level collected from patient's thalassemia diary. Results : Fifty three children was included. Children with normal height (>-2 SD) 54,7%, short height (-2 to -3 SD) 34%, and stunted (<3 SD) 11,3%. Mean Hb pratransfusion 7,66(±0,89) g/dl, Hb posttransfusion 12,41(±0,75) g/dl, and ferritin level 3.034,06 (±1.862,27) µg/l. There was correlation between Hb pascatransfusion with HAZ score (r = 0,37 p = 0,02), but there were no significant correlation between HAZ score with Hb pratransfusion (r= 0,13 p = 0,42) and ferritin level (r = -0,01 p = 0,97). Conclusion : High Hb posttransfusion correlated with high HAZ score in thalassemia major children.

Kata Kunci : thalassemia mayor, Hb pratransfusi, Hb pascatransfusi, kadar ferritin, nilai HAZ