Aktivitas Fosfoupase-A2 Sekretoris Plasma Trombositopenia Demam Berdarah Dengue  

Oleh:

Retnowati K, Endang ; Hidayati S, Wiyanda ; Liana

Jenis: Article from Journal - ilmiah nasional - terakreditasi DIKTI
Dalam koleksi: Indonesian Journal of Clinical Pathology and Medical Laboratory vol. 17 no. 01 (Nov. 2010), page 12-20.
Topik: secretory phospholipase-A2 activity; thrombocytopenia; DHF

Ketersediaan

Perpustakaan FK Nomor Panggil: I01.K.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Infected macrophages by dengue virus will produce phospholipase-A2 (PLA2) enzyme, that can promote arachidollic acid metabolism that produce inflammatory mediators, causing endhoth elial damage and severe plasma leakage. Capillary endothelial damage can cause platelet adhesion and aggregation, so that many platelets will be consumed. The role of sPLA2 (secretory phospholipase-A2), which is a part of PLA2 in dengue and thrombocytopenia up to now has not been widely studied. The objective of the study is to analyze the association between the activity of plasma secretory phospholipase-A, and the degree of thrombocytopenia in DHF adult patients. the study is carried out by a cross sectional, observational analytical study on 45 hospitalized adult patients sufferillg dengue hemorrhagic fever in the Tropical Infection Ward, Department of Internal Medicine, Dr. Soetomo Hospital Surabaya, which has been conducted from February-December 2009. The diagnosis of Dengue Haemorrhagic Fever (DHF) was based 011 the 1997 World Health Organization (WHO) criteria, that minimally had one positive serology marker of dengue. Venous blood was taken from the patien for examining the activity of secretory phospholipase-A2 by correlated enzyme assay method, and platelet count using automated hematology analyzed: The results of the secretory phospholipase-A2 activity and degree of thrombocytopenia were analyzed by Pearson correlation test to determine the correlation between the two variables. In this study so far was found that the secretory phospholipase-A2 activity in DHF patients was 36.9-195.6 unit/mi. (mean 97.49 unit/mL, SD 30.06 unit/mL). The mean of secretory pnosphoupose-A, activity was increased according to the degree of thrombocytopenia severity. The mean of secretory phospholipcse-A, activities were 91.65 unit/mL, 98.94 unit/mL, and 110.47 unit/mL. The degree of thrombocytopenia was divided into mild, moderate, and severe. Most of the patients showed mild thrombocytopenia. The sPLA2 activity in this study was increased in DHF patients with second day of fever, and then decreased at the third and forth day of fever, and increased in DBO patients suffering fifth day of fever. The statistical analyzes show a non significant correlation between secretory phospholipase- A2 activity and degree of thrombocytopenia (p = 0.579). This result may be caused by several factors which influencing the thrombocytopenia in DHF, such as bone marrow suppression, dengue viral serotype, influence of cytosolic pliospholipose-A, (cPLA2) activity, and other proinilommatory cytokines which in this study could not be controlled. Statistical analyzes show a significant correlation between sPLA2 activity and the day of fever (p = 0.04). Further studies should have to be carried out in order to know the pattern of sPLA2 activity in DHF grade 1, 11, 1lI, and IV, and to know the influence of other proinfianuncuory cytokities and viral serotypes in sPLA2 activities.

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