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Rasio Netrofil Limfosit dan Limfositopenia Sebagai Penanda Sepsis

1PPDS1 Bagian Anestesi dan Terapi Intensif, Fakultas Kedokteran, Universitas Diponegoro / RSUP Dr. Kariadi, Indonesia

2Semarang, Indonesia

3Staff Pengajar Bagian Anestesi dan Terapi Intensif, Fakultas Kedokteran, Universitas Diponegoro / RSUP Dr. Kariadi , Indonesia

Published: 1 Jul 2016.

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Abstract

Latar Belakang : Keadaan sepsis pada awalnya akan menyebabkan peningkatan jumlah netrofil diikuti oleh peningkatan limfosit, keadaan sepsis yang bertahan akan menyebabkan apoptosis dari limfosit, sehingga rasio netrofil limfosit akan meningkat, dan terjadi limfositopenia yang dapat dijadikan indikator sepsis.

Tujuan : Mengetahui nilai RNL dan hitung limfosit pada pasien dicurigai sepsis di RSUP Dr. Kariadi Semarang.

Metode : Penelitian ini merupakan penelitian diagnostik non eksperimental dengan desain cross sectional dengan jumlah sampel 30 pasien. Pasien ICU dengan dua atau lebih tanda SIRS dan dicurigai infeksi diambil sampel darah untuk dilakukan pemeriksaan hitung jenis leukosit dan pemeriksaan kultur darah, kemudian data dianalisis menggunakan kurva ROC.

Hasil : Sumber infeksi terbanyak terjadi pada traktus digestivus (43,3%), obstetri ginekologi (23,3%), traktus respiratorius (16,7%), cerebrovaskular (10%) dan traktus urinarius (6,7%). Rasio Netrofil Limfosit memiliki AUC 0,425 (sensitivitas 60% dan spesifitas 20%), Limfositopenia absolut memiliki AUC 0,425 (sensitivitas 40% dan spesifitas 40%), sedangkan RNL dan Limfositopenia memiliki AUC 0,575 (sensitivitas 70% dan spesifitas 45%).

Kesimpulan : Rasio Netrofil Limfosit dan Limfositopenia absolut tidak bisa dijadikan indikator sepsis pada pasien-pasien di ICU walaupun memiliki sensitivitas 70% dan spesisifitas 45%.

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Keywords: Sepsis; Rasio Netrofil Limfosit; Limfositopenia absolut.

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  1. Chang HJ, Sinha S, Moss M. Patient page: Sepsis. J Am Med Association 2010;304:1856-7
  2. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR: Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 2001, 29:1303-1310
  3. Van Gestel A, Bakker J, Veraart CPWM, Van Hout BA. Prevalence and incidence of severe sepsis in Dutch intensive care units. Critical Care 2004, 8:R153-62
  4. Soong J, Soni N. Sepsis: recognition and treatment. Clinical Medicine 2012;12:276–80
  5. Dellinger RP, Levy MM, Rhodes A, Annane D, et al. Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012. Critical Care Medicine. February 2013. 41: 2. 583-5
  6. Nicasio Mancini (ed.), Sepsis: Diagnostic Methods and Protocols, Methods in Molecular Biology, vol.1237. Springer Science Business Media. New York. 2015
  7. Park et al. Delta neutrophil index as an early marker ofdisease severity in critically ill patients with sepsis BMC Infectious Diseases, 11:299. 2011
  8. Xia Y et al. Neutrophil Count to Lymphocyte Count Ratio is a Potential Diagnostic Index for Bacteremia in Adult.Life Science Journal. 2014;11(1).172-7
  9. De Jager et al.Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Critical Care 2010, 14:R192
  10. Okashah AS et al. Ratio of Neutrophil to Lymphocyte Counts as a Simple Marker for Sepsis and Severe Sepsis in Intensive Care Unit. Research and Opinion in Anesthesia & Intensive Care. 2014
  11. Forget et al. Is the Neutrophil-to-Lymphocyte Ratio more correlated than C-reactive protein with postoperative complications after major abdominal surgery?. PeerJ. 2015
  12. Yao YM et al. Sepsis Diagnostic Method and Protocols. Pathophysiological Aspects of Sepsis:
  13. An Overview. Springer Science Business Media. New York. 2015
  14. Monti G et al. Sepsis Diagnostic Method and Protocols. Clinical Aspects of Sepsis: An Overview. Springer Science Business Media. New York. 2015
  15. Lowsby R., Gomes C, Jarman I, Lisboa P, Nee PA, Vardhan M, Eckersly T, Saleh R, Mills H. Neutrophil to Lymphocyte Count Ratio as an Early Inicator of Blood Stream Infection in the Emergency Department. Emerg Med J. 2015; 32(7): 531-534
  16. Ishizuka M, Shimizu T, Kubota K. Neutrophil-to-lymphocyte ratio has a close association with gangrenous appendicitis in patients undergoing appendectomy. Int Surg 2012;97:299-304
  17. Okyay GU, Inal S, Onec K, et al. Neutrophil to lymphocyte ratio in evaluation of inflammation in patients with chronic kidney disease. Ren Fail 2013;35:29-36 Pablo RD, Monserrat J, Prieto A, Alvarez M. Role of Circulating Lymphocytes in Patients with Sepsis. BioMed Research International 2014
  18. Angus CD, Poll T. Severe Sepsis and Septic Shock.N Engl J Med 2013;369:840-51
  19. Russell JA: Management of sepsis. N Engl J Med 2006, 355:1699-1713
  20. Phua et al.: Characteristics and outcomes of culture-negative versus culture-positive severe sepsis. Critical Care 2013 17:R202
  21. Lever A, Mackenzie I: Sepsis: definition, epidemiology, and diagnosis. BMJ 2007, 335:879-883
  22. Dark PM, Dean P, Warhurst G: Benchto-bedside review: the promise of rapid infection diagnosis during sepsis using polymerase chain reactionbased pathogen detection. Crit Care 2009, 13:217
  23. Bloos F, Hinder F, Becker K, Sachse S, Mekontso Dessap A, Straube E, Cattoir V, Brun-Buisson C, Reinhart K, Peters G, Bauer M: A multicenter trial to compare blood culture with polymerase chain reaction in severe human sepsis. Intensive Care Med 2010, 36:241-247
  24. Louie RF, Tang Z, Albertson TE, Cohen S, Tran NK, Kost GJ: Multiplex polymerase chain reaction detection enhancement of bacteremia and fungemia. Crit Care Med 2008, 36:1487-1492
  25. Calandra T, Cohen J: The international sepsis forum consensus conference on definitions of infection in the intensive care unit. Crit Care Med 2005, 33:1538-1548
  26. Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: for the third international consensus definition for sepsis and septic shock (Sepsis-3). JA MA . 2016 Feb 23;315(8):762-774
  27. Liu x, Shen Y, Wang H, Ge Q, Fei A, Pan S. Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Patients with Sepsis: A Prospective Observational Study. Mediators of Inflammation. Hindawi Publishing Corporation. 2016
  28. Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS: Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008, 102:653-657
  29. Halazun KJ, Hardy MA, Rana AA, Woodland DCt, Luyten EJ, Mahadev S, Witkowski P, Siegel AB, Brown RS Jr, Emond JC: Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma. Ann Surg 2009, 250:141-151

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