HUBUNGAN JUMLAH LEUKOSIT SERTA KADAR C-REACTIVE PROTEIN DENGAN DERAJAT KEPARAHAN PNEUMONIA PADA ANAK

Abstract

Pneumonia merupakan salah satu penyebab kematian terbesar pada bayi dan balita. Sitokin-sitokinproinflamasi akan dilepaskan pada saat infeksi sehingga menyebabkan perubahan sistemik. Penandainflamasi sistemik seperti jumlah leukosit dan kadar C-reactive protein (CRP) dapat membantumenentukan derajat keparahan pada pneumonia. Penelitian ini bertujuan untuk mengetahui hubunganjumlah leukosit serta kadar CRP dengan derajat keparahan pneumonia pada anak. Penelitian analitik,dengan desain potong lintang, melibatkan 28 anak dengan pneumonia berat dan sangat berat.Pemeriksaan laboratorium seperti jumlah leukosit dan kadar CRP dilakukan pada subjek penelitian.Pneumonia sangat berat mempunyai rerata kadar CRP lebih tinggi [42,69 (SB 41,70)] dibandingkandengan pneumonia berat [2,95 (SB 3,03)]. Kadar CRP berbeda bermakna pada pneumonia berat dansangat berat [beda rerata 39,74 (IK95% 16,76 sampai 62,71) mg/L, P=0,003], namun jumlah leukosittidak berbeda bermakna [beda rerata 1,75 (IK95% -8,62 sampai 5,12) x 103 u/L, P=0,605]. Analisismultivariat menunjukkan derajat keparahan pneumonia dipengaruhi oleh kadar CRP [RO 1,46 (IK95%1,02 sampai 2,10), P=0,040], sedangkan jumlah leukosit tidak berhubungan dengan derajat keparahanpneumonia pada anak. Disimpulkan, kadar CRP berhubungan dengan derajat keparahan pneumoniapada anak. [MEDICINA 2015;46:77-81].

Pneumonia is the biggest causes of death in infants and children under five years old. At the time ofinfection, proinflammatory cytokines would be released and caused systemic changes. Markers ofsystemic inflammation like leukocyte count and C-reactive protein (CRP) level can help to determinethe degree of severity of pneumonia. The aim of this study was to evaluate the association betweenleukocyte count and CRP level with the degree of severity of pneumonia in children. An analytic crosssectional study was done on 28 children with severe and very severe pneumonia at Sanglah HospitalDenpasar, who fulfilled the inclusion and exclusion criteria. Subjects were conducted laboratoricexamination includes testing the leukocyte count and CRP level. Very severe pneumonia had a highermean CRP level [42.69 (SD 41.70)] compared with severe pneumonia [2.95 (SD 3.03)]. There was asignificant difference between CRP level in severe and very severe pneumonia cases [mean difference39.74 (95%CI 16.76 to 62.71) mg/L, P=0.003], but there was not any significant difference in theleukocyte count [mean difference 1.75 (95%CI -8.62 to 5.12) x 103 u/L, P=0.605]. Multivariate analysisshowed that severity of pneumonia was influenced by CRP level [OR 1.46 (95%CI 1.02 to 2.10), P=0.040],but leukocyte count is not associated with the degree of severity of pneumonia. In conclusion, CRP levelis associated with the degree of severity of pneumonia. [MEDICINA 2015;46:77-81].