Analisis Nilai NLR, MLR, dan PLR Penderita Tuberkulosis Sebelum dan Sesudah Pengobatan Oat

I Gusti Agung Ayu Satwikha Dewi
I Putu Riska Ardinata (Universitas Bali Internasional)
Ni Luh Eka Kartiningsih (Universitas Bali Internasional)
Dewa Ayu Trisna Dewi (Universitas Bali Internasional)
I Nyoman Jirna (Poltekkes Kemenkes Denpasar)
I Gusti Ngurah Dwija Putra (Poltekkes Kemenkes Denpasar)
Dewa Gede Eka Prayoga (Badan Riset Daerah Kabupaten Karangasem)

Bali Medika Jurnal
Vol 13 No 1 (2026): Bali Medika Jurnal July 2026

Tuberculosis (TB) is an infectious disease that remains a global health challenge, including in Bali Province. Denpasar City was recorded as the region with the highest number of TB cases in 2022. The long duration of TB treatment often causes side effects such as nausea, vomiting, and liver dysfunction, which impacts low patient compliance. Assessment of immunological conditions through hematological parameters such as the Neutrophil Lymphocyte Ratio (NLR), Monocyte Lymphocyte Ratio (MLR), and Platelet Lymphocyte Ratio (PLR) is considered potential as an indicator of the effectiveness of ATD (anti-tuberculosis drug) therapy. This study aims to analyze changes in NLR, MLR, and PLR values before and after ATD therapy in TB patients at Denpasar City Community Health Centers. This study is a prospective cohort study using the Accidental Sampling method in 11 Community Health Centers. EDTA blood samples were analyzed using an automated hematology analyzer, and data were tested using normality tests and Pearson correlation. The results showed that the pre-ATD NLR values (mean 2.29) and post-ATD remained normally distributed with a weak and insignificant positive correlation (p = 0.294). The pre-ATD MLR values (mean 0.35) and post-ATD had a weak and insignificant negative correlation (p = 0.412). Similarly, the pre-ATD PLR (mean 12.82) and post-ATD showed a weak and insignificant negative correlation (p = 0.315). The conclusion of this study is that ATD treatment for two months has not provided significant changes in the NLR, MLR, and PLR values. Continued monitoring until the end of therapy is still needed to comprehensively assess the effectiveness of ATD.   Tuberkulosis (TB) merupakan salah satu penyakit menular yang masih menjadi tantangan kesehatan global, termasuk di Provinsi Bali. Kota Denpasar tercatat sebagai wilayah dengan jumlah kasus TBC tertinggi pada tahun 2022. Durasi pengobatan TBC yang panjang sering menimbulkan efek samping seperti mual, muntah, dan gangguan fungsi hati, yang berdampak pada rendahnya pemenuhan pasien. Penilaian kondisi imunologis melalui parameter hematologi seperti Rasio Limfosit Neutrofil (NLR), Rasio Limfosit Monosit (MLR), dan Rasio Limfosit Trombosit (PLR) dinilai berpotensi sebagai indikator efektivitas terapi OAT (obat anti tuberkulosis). Tujuan: menganalisis perubahan nilai NLR, MLR, dan PLR sebelum dan sesudah terapi OAT pada pasien TB di Puskesmas Kota Denpasar. Metode: Studi kohort prospektif pre-post pada 32 pasien TB baru. Sampel darah diambil sebelum OAT dan hari ke-56 metode Accidental Sampling di 11 Puskesmas. Analisis menggunakan uji t berpasangan. Hasil: Rata-rata pre-OAT: NLR=2.29±0.78, MLR=0.35±0.15, PLR=12.82±4.04. Pasca-OAT: NLR=2.34±0.81 (p=0.63), MLR=0.33±0.14 (p=0.27), PLR=12.50±4.20 (p=0.53). Tidak ada perubahan signifikan pada ketiganya. Simpulan penelitian ini adalah pengobatan OAT selama dua bulan belum mengubah biomarker inflamasi hematologis (NLR, MLR, PLR). Pemantauan hingga 6 bulan diperlukan untuk evaluasi respons terapi.