Faktor Hemostosis dan Faktor Kebocoran Vaskuler sebagai Faktor Deskriminan untuk memprediksi syok pada Demam Berdarah Dengue.

Tahun 2005 Volume 40 Nomor 2
Oleh : Tatty Ermin Setiati

Pendahuluan : Angka kematian Demam Berdarah Dengue (DBD) <3% tetapi di PICU : Angka kematian Sindrom SyokDengue (SSD) masih tinggi yaitu 51.2% . Penelitian terdahulu , belum dapat menarik kesimpulan mengenai faktor prediktor syok  pada DBD . Tujuan penalitian ini untuk membuktikan peranan faktor hemostosis dan faktor kebocoran vaskuler pada DBD

Metode:
Desain penelitian ini adalah studi obseravsional , cross sectional , yang sekuensial . Seratus lima puluh penderita DBD umur 3-14 tahun yang dirawat di Rs. Dr.Kariadi Semarang ddimasukkan dalam penelitian secara consecutive sampling. Terhadap penderita dilkukan pemeriksaan fisik lengkap, faktor hemostosis , fakor kebocoran askuler, isfungsi endotel yaitu vWF-Ag , PAI-1 , Dan mikropartikel . Diagnosis DBD ditegakkan berdasarkan kriteria WHO 1997 dikonfirmasikan dengan uji serologis. Pengujian data menggunakan analisis diskriminan dan repeated measure.

Hasil:
Dua belas anak dikeluarkn dari penelitian dan 8 meninggal . Sampel menjadi 66 anak dengan SSD dan 64 anak dengan Non-SSD .Urutan peranan faktor hemositasis dan faktor kebocoran vaskuler antara hari pengamatan pada SSD dan Non SSD


Simpulan:
Faktor Hemositosis dan kebocoran vaskuler terbukti merupakan faktor deskriminan untuk memprediksi syok pada DBD. Urutan dalam memprediksi syok berubah ubah antara hari pengamatan.

Hemostatic and vascular Leakage Factors as Descriminant Factors to predict shock in DHF patients

Background: Mortality rate for dengue Hemorhagic fever(DHF) is <3% , but for dengue schock syndrome (DSS) in perintal Intensife care unit (PICU) is 51,2%. previous studied on DHF in children have  come up with conclusion of factor to predict shock. The purpose of the study was to identify hemostatic and vascular leakage factors as predictors for shock in DHF patients

Methods:
The study ws an observasional , cross sectional , and seqential study, One hundred and fifty patients with DHF aged 3 – 14 years  hospitalized in DR. Kariadi Semarang were taken for the study using consecurive sampling.Patient undergone complete physical , hemosaric,vascular leakage, endothel dysfunction (vWF-Ag,PAI- 1) , and microparticle examinations. Diagnosisi of DHF was in acordance to WHO 1997 criteria , confirmed with serologic examinations. Discriminant and repeat measure analyses were used

Result:
Twelve patients were axluded and 8 died. The remaining patients were 66 DSS AND 64 non DSS patients . Role sequence of hemostatic and vascular leakage factors in predicting shock in DHF patients during observation days changed simultaneously and sequently. There were significant differences of the mean and kinetics of hemostatic and vascular laekage factor during observation days between DSS and non DSS patients using repeated measure analyses.


Conclusion:
This study proved that hemostatic and vascular leakage foctors were descriminant factors to predict shock in DHF patients .Role sequence in predicting shock also changed during observation day