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CORRELATION BETWEEN NT-PROBNP AND LEFT VENTRICULAR EJECTION FRACTION BY ECHOCARDIOGRAPHY IN HEART FAILURE PATIENTS Mutiara DS; Leonita Anniwati; M. Aminuddin
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 2 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i2.1131

Abstract

Petanda biologis NH2-terminal fragment of proBrain Natriuretic Peptide (NT-proBNP) berguna untuk diagnosis dini, menyingkirkangejala klinis yang berasal dari luar jantung serta pemantauan pengobatan dan meramalkan perjalanan penyakit pasien gagal jantung.Pemeriksaan NT-proBNP dapat dilakukan secara otomatis, sehingga hasil tidak bersifat subjektif. Pemeriksaan ekokardiografi merupakanpemeriksaan penunjang yang telah umum digunakan untuk mendiagnosis gagal jantung. Namun, pemeriksaan ekokardiografi tidakselalu tersedia di seluruh rumah sakit, khususnya rumah sakit di daerah, serta memerlukan tenaga ahli untuk melakukan pemeriksaandan hasil pemeriksaan bersifat subjektif. Salah satu tolok ukur yang dinilai pada pemeriksaan ekokardiografi adalah fraksi ejeksiventrikel kiri. Penelitian ini bertujuan untuk mengetahui kenasaban antara kadar NT-proBNP dengan fraksi ejeksi ventrikel kiri yangdiperoleh dari pemeriksaan ekokardiografi. Penelitian bersifat quasi experimental dengan pendekatan pretest and posttest only withoutcontrol. Sampel penelitian berjumlah 41 orang, dikumpulkan selama bulan Februari–April 2015 dari Ruang Perawatan Jantung RSUDDr. Soetomo Surabaya. Pemeriksaan kadar NT-proBNP menggunakan metode chemiluminescent (Immulite 1000) dengan prinsip solidphasetwo site chemiluminescent immunometric assay. Hasil dianalisis secara statistik menggunakan uji kenasaban Spearman’s, ujit 2 sampel berpasangan, Kruskal Wallis dan Mann Whitney. Rentang kadar NT-proBNP sebelum dan sesudah pemberian pengobatandi pasien gagal jantung masing-masing antara 1.296–34.374 pg/mL dengan rerata 10.422,49 pg/mL (Simpang Baku (SB) 8.608,05)dan 997–34.401 pg/mL dengan rerata 8.899,41 pg/mL (SB 8.489,46). Rentang persentase fraksi ejeksi ventrikel kiri sebelum dansesudah pemberian pengobatan di pasien gagal jantung masing-masing antara 20–62% dengan rerata 35,61% (SB 10,00) dan 22–71%dengan rerata 41,49% (SB 10,96). Didapatkan perbedaan bermakna rerata kadar NT-proBNP serta persentase fraksi ejeksi ventrikel kirisebelum dan sesudah pemberian pengobatan di pasien gagal jantung dengan setiap nilai p=0,001. Didapatkan kenasaban negatif yangbermakna antara kadar NT-proBNP dan fraksi ejeksi ventrikel kiri di pasien gagal jantung sebelum dan sesudah pemberian pengobatandengan masing-masing nilai p=0,001, r=-0,81 dan nilai p=0,001, r=-0,80. Didapatkan kenasaban negatif yang bermakna antarakadar NT-proBNP dengan fraksi ejeksi ventrikel kiri di pasien gagal jantung sebelum dan sesudah pemberian pengobatan. Berdasarkanhal tersebut maka pemeriksaan petanda biologis NT-proBNP dapat diusulkan untuk digunakan sebagai tolok ukur pilihan penggantiekokardiografi untuk gagal jantung.
METODE BROMCRESOL GREEN (BCG) DAN BROMCRESOL PURPLE (BCP) PADA SIROSIS HATI YANG MENDAPAT INFUS ALBUMIN Miftahul Ilmiah; Leonita Anniwati; Soehartini Soehartini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 2 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i2.1070

Abstract

Albumin infusion is one of the therapeutic options in hypoalbuminemia patients. Serum albumin can be used to determine the albumininfusion therapy, prognosis and monitoring of liver cirrhosis. The time difference in measurement of serum albumin by bromcresol green(BCG) and bromcresol purple (BCP) methods can give different results. Serum albumin examination was done in 20 sera taken fromcirrhosis patients. Serum albumin was then evaluated before treatment, one (1) hour and 24 hours after the patient received an infusionof albumin and examined by bromcresol green (BCG) and bromcresol purple (BCP) methods. The serum albumin level by BCG methodincreased with a coefficient of 0.12 (p-value=0.022) with BCG method before (1.94±0.32 mg/dL) and after one (1) hour (2.06±0.32mg/dL) receiving intravenous albumin. The coefficient of albumin levels before and after 24 hours (2.12±0.38 mg/dL) was 0.18 (pvalue=0.07), whereas the increased levels of serum albumin after one (1) hour and after 24 hours of intravenous albumin, were notsignificant (p-value=0.467). The BCP method showed that serum albumin before, after one (1) hour and after 24 hours receivingintravenous albumin were 1.68±0.36 mg/dL, 1.87±0.36 mg/dL and 2.12±0.63 mg/dL respectively. The albumin levels showed asignificant increase before and after one (1) hour infusion of albumin (p-value=0.00), both levels shown before and after 24 hours(p-value=0.001), as well as one (1) hour and 24 hours after receiving intravenous albumin (p-value=0.04). The results of this studyshowed that increased serum albumin by BCG method could be detected after 1 (one) hour, whereas by BCP method could only be detectedafter 24 hours receiving intravenous albumin.
ALBUMIN SERUM DALAM SIROSIS HATI Windu Nafika; Leonita Anniwati; Soehartini Soehartini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 1 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i1.435

Abstract

Serum albumin measurement can be used for assessing prognosis, determining initial therapy and treatment efficacy for liver cirrhosis patients. The discrepancy result of albumin measurement using different methods can make bias for the albumin concentration. The measurement of albumin was carried out in 20 sera of liver cirrhosis patients using bromcresol green (BCG), BCG conversion as well as bromcresol purple (BCP) methods including protein electrophoresis. The results showed that BCP method has a lower albumin concentration than the other kind (1.68±0.35), BCG (1.94±0.31), BCG conversion (2.09±0.45) as well as protein electrophoresis (2.14±0.35). BCP method has a good correlation with protein electrophoresis as well as BCG conversion (r=0.935 and r=0.90 respectively). It can be concluded in this study, that albumin measurement with BCP method has a good correlation with protein electrophoresis. It is important to know that the measurement results of BCP method is lower but more accurate in the albumin concentration, because there is no cross reaction with globulin. That means, there is no overestimation of albumin concentration in hypoalbuminemia condition of the patients.
PERBANDINGAN PEMERIKSAAN TRIGLISERIDA METODE GLYCEROL BLANKING DAN NON GLYCEROL BLANKING PADA SIROSIS HEPATIS Sri Widyaningsih; Leonita Anniwati; Juli Soemarsono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 1 (2012)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i1.393

Abstract

Liver cirrhosis is a chronic liver disease with fibrosis and impairment of function. In liver disease increasing endogenous free glycerol has been found which constitutes a source of interference in the measurement of (TG). The aim of this study is to compare the glycerol blanking (TG-GB) which does not interfere with endogenous free glycerol to non glycerol blanking (TG-NGB) method in measuring TG in liver cirrhosis patients. In this study, sera were obtained from 22 liver cirrhosis and 30 healthy persons. All sera were measured for TG using TMS 1024i (Tokyo Boeki Medical System) with glycerol blanking (TG-GB) to non glycerol blanking (TG-NGB) method. In addition to this study, measurement of free glycerol was also compared to difference calculated TG-NGB and TG-GB in liver cirrhosis patients. The mean of TG-GB and TG-NGB measurements from healthy persons was 115.30±70.35 mg/dL and 121.27±67.14 mg/dL (p=0.108), respectively. The mean of TG-GB and TG-NGB measurements from liver cirrhosis patients was 101.09± 78,55 mg/dL and 120.91±79.44 mg/dL (p<0.0001). There was a significant difference between TG-GB and TG-NGB, and there was no significant difference between measurement of free glycerol to difference calculated TG-NGB and TG-GB in liver cirrhosis (p=0.784). However, there was a significant correlation between TG-GB and TG-NGB in healthy persons and liver cirrhosis patients. (p<0.0001). The measurement of TG-GB is more accurate than TG-NGB method in liver cirrhosis patients.