Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Kadar Protein Total Plasma Dan Fraksinya

Peranan protein plasma dalam manifestasi klinis dan komplikasi sindrom nefrotik (SN) sangat besar. Penyebab utama menurunnya protein plasma pada SN adalah proteinuria. Proteinuria yang berulang-ulang terjadi pada SN kambuh sering (SNKS) dan kambuh jarang (SNKJ) akan merubah gambaran protein plasma dan fraksi-fraksinya. Penelitian ini bertujuan untuk mengetahui perbandingan kadar protein total, albumin, alfa 1, alfa 2, beta, dan gama globulin plasma penderita SNKS dengan SNKJ. Penelitian ini dirancang berupa studi cross-sectional. Subjek penelitian adalah anak berusia 1–14 tahun yang terdiri dari 18 orang penderita SNKS dan 22 orang penderita SNKJ diambil dari data sekunder rekam medik penderita SN kambuh di RS dr. Hasan Sadikin antara tahun 2001 sampai 2005. Analisis statistik menggunakan uji t dan Mann-Whitney dan kemaknaan ditentukan berdasarkan nilai p<0,05. Usia, jenis kelamin, derajat proteinuria antara kelompok SNKS dan SNKJ tidak menunjukkan adanya perbedaan yang bermakna (masing-masing p=0,180; p=0,093; p=0,108). Rerata kadar albumin, protein total, dan gama globulin pada kelompok SNKS dan SNKJ lebih rendah dibandingkan dengan nilai normal. Rerata kadar protein total pada kelompok SNKS dan SNKJ masing-masing adalah 4,011 dan 4,336 g/dL, kadar albumin adalah 1,204 dan 1,451 g/dL kadar gama globulin 0,394 dan 0,589 g/dL. Sedangkan rerata kadar alfa 1-globulin, alfa 2-globulin, dan beta globulin pada kelompok SNKS dan SNKJ masih dalam batas normal. Rerata kadar alfa 1-globulin pada kelompok SNKS dan SNKJ masing-masing adalah 0,143 dan 0,158 g/dL, kadar alfa 2-globulin 1,600 dan 1,607 g/dL, kadar beta globulin 0,605 dan 0,610 g/dL. Perbandingan rerata kadar protein total, albumin, alfa 1-globulin, alfa 2-globulin, beta globulin antara kelompok SNKS dan SNKJ secara statistik perbedaannya tidak bermakna (masing-masing p=0,251, p=0,256, p=0,491, 0,757, p=0,931), sedangkan rerata kadar gama globulin menunjukkan perbedaan yang bermakna (p=0,029). Kesimpulannya adalah kadar gama globulin pada kelompok SNKS lebih rendah daripada kelompok SNKJ, sedangkan kadar albumin, protein total, alfa 1-globulin, alfa 2-globulin, dan beta globulin menunjukkan hasil yang tidak berbada antara dua kelompok tersebut.

Plasma protein plays such a major role in clinical manifestations and complications of nephrotic syndrome (NS). The main cause of decrease of plasma protein in NS is proteinuria. Recurrent proteinuria in frequent relapses NS (FRNS) and infrequent relapses (IFRNS) will change plasma protein and its fraction profiles. The purpose of this study was to compare level of total protein, albumin, alpha-1, alpha-2, beta, and gamma globulin between FRNS and IFRNS. This is a cross sectional study. Subjects were children age 1-14 years old, 18 children were FRNS and 22 children were IFRNS. Secondary data were taken from medical record of Hasan Sadikin Hospital from 2001-2005. Statistical analysis was performed using t-test and Mann-Whitney. statistical significance was p < 0.05. There were no significant differences in age, sex, and degree of proteinuria between FRNS and IFRNS groups (p=0.18; p=0.093; p=0.108). The mean levels of albumin, total protein, and γ-globulin in both groups were under normal values. Total protein levels in FRNS and IFRNS groups were 4.011 and 4.336 g/dL, albumin levels were 1.204 and 1.451 g/dL, and γ-globulin levels were 0.394 and 0.589 g/dL, consecutively. The mean levels of α-1 globulin, α-2 globulin, and β-globulin in both groups were within normal limit. Level of α-1 globulin in FRNS and IFRNS groups were 0.143 and 0.158 g/dL, α-2 globulin were 1.600 and 1.607 g/dL, β-globulin were 0.605 and 0.610 g/dL. The average ratio of total protein, albumin, α-1 globulin, α-2 globulin, and β-globulin between 2 groups were not statistically significant (p=0.251; p=0.256; p=0.491; p=0.757; p=0.931). On the other hand, the mean level of γ-globulin showed significant differences between FRNS and IFRNS groups (p=0.029). It is concluded that FRNS group has lower γ-globulin level than IFRNS group, no difference found in level of albumin, total protein, α-1 globulin, α-2 globulin, and β-globulin in both groups.

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