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Perbandingan Peningkatan Enzim Aminotransferase pada Demam Dengue Primer dan Sekunder

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Dengue fever (DF) is still a health problem in Indonesia where primary DF ussually gives less symptom then secondary DF. DF had been known to assail on liver cells (hepatitis) that gives increase Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) enzymes level, and dengue hepatitis can be serious until fatal. Therefore increased level of transaminase in DF (primary or secondary) need to be observed and examined. Differentiation between primary DF and secondary DF can be made by measuring Ig G & Ig M level in patients’ blood specimen.

The aim of this study to compare and observe the differences of aminotransferase enzymes level in primary DF and secondary DF. Retrospective study was conducted using medical records from some hospitals in Malang during January 2006 until June 2009. Primary and secondary DF was distinguish using Ig G & Ig M Immunochromatography dengue Rapid Test (ICT DFRT). Secondary DF was divided into group I : positive Ig G & Ig M ICT-DRFT, and group II : positif ig G but negatif Ig M ICT-DRFT while primary DF (group III) was derive from positive Ig M ICT DFRT only. Clinical chemistry parameters was conducted using chemical autoanalyzers. Results were analyzed using student t-test & ANOVA using SPSS 11 with degree of confidence p < 0.05.

There are 1831 DF cases that comprised in group I (1192), II (264) and III (375), but aminotransferase enzymes level was 467 cases (I), 99 cases (II) and 101 cases (III). Therefore our results on aminotransferase enzymes level was conducted only 26.93 - 39.18% from total cases, that comprises as follows 39.18% (I); 37.5% (II); 26.93% (III). Range, mean and standard deviation in aminotransferase enzymes level was AST I : 5 - 4700 U/L (194.86 + 425.91); ALT I : 6 - 2310 U/L (125.26 + 258.18); AST II 7 - 13450 U/L (342.63 + 1504.48); ALT II : 4 - 4010 U/L (153.63 + 517.02); AST III : 11-486 U/L (91.32 + 83.33); ALT III : 12 – 297 U/L (66.32 + 53.92), respectively. There are significant differences between group I and III (p 0.05). Comparison of the 3 group using ANOVA shows significant difference only in AST level (p = 0.035) while ALT is no significant difference (p=0.074). AST enzymes level > 20 times upper normal limit was : 3.86% (I), 5.05% (II), 0.00% (III), and 4.06% (I+II), respectively. ALT enzymes level > 20 times upper normal limit was : 2.79% (I), 2.02% (II), 0.00% (III), and 2.47% (I+II), respectively.

There is significant difference aminotranferase enzymes level in primary DF and secondary DF, while in two group of secondary DF (between I and II) shows no significant difference in aminotransferase enzymes level. Patient primary and secondary DF shows main difference in AST level that is higher than ALT. Increase of AST > 20 times upper normal limit in secondary dengue in group II is higher that group I (5.05% vs 3.86%) while increase of ALT > 20 times upper normal limit shows higher in group I rather than group II (2.47% vs 2.02%). Therefore it is advised to perform aminotransferase enzymes examination in dengue fever

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Series Title

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Call Number

Medika;36(2)2010:90-95

Publisher

Jakarta : PT. Grafiti Medika Pres., 2010

Collation

5p.

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ISBN/ISSN

0216-0910

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Subject(s)

dengue
enzymes
TRANSAMINATES

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