Kadar Calprotectin pada Bayi Kurang Bulan dan Respiratory Distress Syndrome

Abstract

Calprotectin merupakan peptida antimikrob yang disimpan dalam leukosit sebagai molekul efektor dari respons imun innate. Terdapat infeksi intrauterin/intraamnion berhubungan dengan peningkatan calprotectin, defensin, dan bacterial permeability increasing protein (BPI) secara bermakna di dalam cairan amnion pada persalinan kurang bulan. Penelitian ini bertujuan untuk mengetahui kadar calprotectin pada bayi kurang bulan yang menderita dan tidak menderita respiratory distress syndrome (RDS). Penelitian observasional analitik dilakukan selama periode Maret 2010–Maret 2012 di RS Dr. Hasan Sadikin, RS Advent, RS Al Islam, RS Khusus Ibu dan Anak Kota Bandung, dan RS Ibu Anak Hermina Pasteur, diperoleh sampel sebanyak 60 bayi kurang bulan yang menderita dan tidak menderita RDS masing-masing sejumlah 30 orang. Cairan amnion diambil untuk pemeriksaan kadar calprotectin. Diagnosis RDS dibuat berdasarkan pemeriksaan fisis, skor Downe, dan foto toraks. Didapatkan nilai median kadar calprotectin pada kelompok bayi kurang bulan yang menderita RDS 3.302,6 sedangkan pada kelompok bayi yang tidak menderita RDS 7.908,85. Pada uji Mann-Whitney diperoleh Zm-w=3,063 (p=0,002). Cut-off point (COP) calprotectin >3.395,6 didapatkan jumlah RDS (+) 17 dan RDS (-) 4, sedangkan pada COP calprotectin >3.395,6 jumlah RDS (+) 13 dan RDS (-) 26. Dapat disimpulkan, kadar calprotectin pada bayi yang menderita RDS berbeda dibandingkan dengan kadar calprotectin pada bayi yang tidak menderita RDS. Kadar calprotectin dapat memprediksi kejadian RDS dengan sensitivitas 56,7%; spesifisitas 86,7%; dan akurasi 71,7%.

CALPROTECTIN CONCENTRATIONS IN PRETERM NEONATES  AND RESPIRATORY DISTRESS SYNDROME

Calprotectin is antimicrobial peptides stored in leucocytes, that acts as effector molecules of the innate immune response. Intrauterine or intraamniotic infection was associated with a significant increase in amniotic fluid concentration of calprotectin, defencin and bacterial permeability increasing protein (BPI). The study aims to explore calprotectin concentrations at preterm neonates with and without respiratory distress syndrome. An observational analytic study was performed during March 2010-March 2012 in Dr. Hasan Sadikin, Advent, Al Islam, Bandung Mother and Child and Hermina Pasteur Hospitals. Subjects were 60 preterm neonates who divided in two groups, 30 neonates with and 30 neonates without RDS. Sixty samples of amniotic fluid were collected to examine calprotectin concentration. The diagnoses of RDS were made based on physical examination, Downe score and chest X-rays. Median value of calprotectin concentrations from preterm neonates with RDS were 3,302.6 and neonates without RDS were 7,908.85, with Mann-Whitney test Zm-w=3.063 (p=0.002). Cut off point (COP) of calprotectin 3,395.6 in RDS (+) were 17 and in RDS (-) were 4. Calprotectin in RDS COP >3,395.6 (+) were 13 and RDS (-) were 26. In conclusion, the concentration of calprotectin at RDS (+) is very low and significantly different with the one  at RDS (-). The concentration of calprotectin can be used to predict the incidence of RDS with sensitivity 56.7%, specificity 86.7% and accuracy 71.7%.