LAPORAN PRAKTIKUM BIOKIMIA KEDOKTERAN II

PEMERIKSAAN KARBOKSIHEMOGLOBIN
(HbCO)


Disusun Oleh :
Naa : Ga!a Saa!a B!a"a#en$a
NIM : KIA%%&%'(
Kel)*)+ : I,
Asis$en : Gha-ia Se+a! Ne.a!i
PROGRAM PENDIDIKAN DOKTER
UNI,ERSITAS /ENDERAL SOEDIRMAN
PUR0OKERTO
1%%'
LAPORAN PRAKTIKUM BIOKIMIA KEDOKTERAN II
PEMERIKSAAN KARBOKSIHEMOGLOBIN
(HbCO)
OLEH
Nama : Gara Samara Brajadenta
NIM : KA!!"!#$
Ke%&m'&( : I)
D*+,+,n ,nt,( memen,-* t,.a+ 'ra(t*(,m B*&(*m*a Ked&(teran II
Pada Pr&.ram St,d* Pend*d*(an D&(ter
Un*/er+*ta+ 0endera% S&ed*rman
P,r1&(ert&
D*ter*ma dan d*+a-(an
P,r1&(ert&2 O(t&ber 3!!#
A+*+ten2
G-a4*a Se(ar Ne.ar*
NIM KA!!5!6#
I2 /u#ul P!a+$i+u
Pemer*(+aan Karb&(+*-em&.%&b*n (HbCO)7
II2 Tan..al P!a+$i+u
Sabt,2 6 O(t&ber 3!!#7
III2 Tu"uan P!a+$i+u
7 Men.,(,r (adar (arb&(+*-em&.%&b*n (HbCO)7
37 Menje%a+(an n*%a* n&rma% (arb&(+*-em&.%&b*n (HbCO) +erta n*%a*
'at&%&.*+ dar* -a+*% 'ra(t*(,m7
57 Me%a(,(an d*a.n&+a d*n* 'en8a(*t a'a +aja 8an. d*+ebab(an &%e- -a+*%
(arb&(+*-em&.%&b*n (HbCO) abn&rma% 9 'at&%&.*+ me%a%,* bant,an -a+*%
'ra(t*(,m 8an. d*%a(,(an7
I,2 Dasa! Te)!i
Hem&.%&b*n mer,'a(an '*.men mera- 8an. memba1a &(+*.en da%am
+e% dara- mera-2 8a*t, +,at, 'r&te*n den.an berat m&%e(,% $"7"#! Da%t&n7
Hem&.%&b*n ada%a- +,at, m&%e(,% 8an. berbent,( b,%at 8an. terd*r* dar* "
+,b,n*t7 Set*a' +,b,n*t men.and,n. +at, ba.*an -eme 8an. ber(&nj,.a+*
den.an +,at, '&%*'e't*da7 Heme ada%a- +,at, der*/at '&r:*r*n 8an.
men.and,n. be+*7 P&%*'e't*da *t, +e;ara (&%e(t*: d*+eb,t +eba.a* ba.*an
.%&b*n dar* m&%e(,% -em&.%&b*n7 Hem&.%&b*n men.*(at O3 ,nt,( membent,(
&(+*-em&.%&b*n2 O3 menem'e% 'ada <e
3=
da%am -eme7 A:*n*ta+ -em&.%&b*n
ter-ada' O3 d*'en.ar,-* &%e- 'H2 +,-,2 dan (&n+entra+* 325>d*:&+:&.%*+erat
(325>DPG) da%am +e% dara- mera-7

Da%am menja%an(an :,n.+*n8a memba1a &(+*.en (e +e%,r,- t,b,-2
-em&.%&b*n d* da%am +e% dara- mera- men.*(at &(+*.en me%a%,* +,at, *(atan
(*m*a (-,+,+7 Re(a+* 8an. membent,( *(atan antara -em&.%&b*n den.an
&(+*.en ter+eb,t da'at d*t,%*+(an +eba.a* ber*(,t
Hb = O3 ? HbO3
Rea(+* ter+eb,t ber%an.+,n. da%am d,a ara-7 Rea(+* (e ara- (anan mer,'a(an
rea(+* 'en..ab,n.an ata, a+&+*a+* 8an. terjad* d* a%/e&%,+ 'ar,>'ar, tem'at
ber%an.+,n.n8a 'ert,(aran ,dara antara t,b,- den.an %*n.(,n.an2 +edan.(an
rea(+* (e ara- (*r* ada%a- rea(+* 'en.,ra*an ata, d*+&+*a+* ter,tama terjad* d*
jar*n.an7 Den.an dem*(*an2 da'at d*(ata(an ba-1a -em&.%&b*n da%am +e% dara-
mera- men.*(at &(+*.en d* 'ar,>'ar, dan me%e'a+(ann8a d* jar*n.an2 ,nt,(
d*+era-(an dan d*.,na(an d* +e%>+e%7 Hem&.%&b*n 8an. t*da( ata, be%,m
men.*(at &(+*.en d*+eb,t +eba.a* de&(+*-em&.%&b*n ata, de&(+*Hb dan
,m,mn8a da'at d*t,%*+ +eba.a* Hb +aja7
<,n.+* %a*n dar* +e% dara- mera- ada%a- men.*(at dan mem'erm,da-
tran+'&rta+* .a+ CO3 8an. terbent,( d* +e%,r,- jar*n.an 8an. mam',
me%a(,(an metab&%*+me +e;ara aer&b2 ,nt,( d*ba1a (e jar*n.an 'emb,an.an
e(+(reta 8an. berbent,( .a+2 8a*t, 'ar,>'ar,7 Den.an dem*(*an2 d* da%am 'ar,>
'ar, terjad*%a- 'ert,(aran .a+ den.an %*n.(,n.an: &(+*.en d*amb*% dar*
%*n.(,n.an dan CO3 d*(e%,ar(an (e %*n.(,n.an7 Ada%a- +arana 8an. +ama2 8a*t,
+e% dara- mera-2 8an. d*.,na(an ,nt,( 'r&+e+ tran+a(+* .a+ antara +e% t,b,-
den.an %*n.(,n.an7 Berbeda den.an &(+*.en2 8an. -am'*r +em,an8a ber*(atan
%an.+,n. den.an m&%e(,% Hb da%am bent,( &(+*-em&.%&b*n2 ma(a -an8a
+eba.*an +aja dar* CO3 8an. ber*(atan %an.+,n. den.an m&%e(,% Hb me%a%,*
*(atan (arbam*n&2 ber,'a HbCO37 Seba.*an 8an. %eb*- be+ar dar* CO3 *n* j,+tr,
d*an.(,t +eba.a* bent,( ter%ar,t da%am '%a+ma7 A(an teta'* berbeda den.an
&(+*.en2 CO3 ter+eb,t t*da(%a- %ar,t +e;ara :*+*( da%am bent,( +en8a1a ter+eb,t2
a(an teta'* +eba.a* *&n b*(arb&nat (HCO5
>
)2 8an. 'embent,(ann8a +an.at
memer%,(an +e% dara- mera-7 D* da%am +e% dara- mera- terda'at en4*m
an-*dra+e (arb&nat 8an. men.(ata%*+ rea(+* ber*(,t:
CO3 = H3O H3CO5 H
=
= HCO5
>

A+am (arb&nat *&n b*(arb&nat
I&n b*(arb&nat 8an. terbent,( d* da%am +e% dara- mera- (arena (erja en4*m *n*2
berd*:,+* (e%,ar dar* +e% ter+eb,t dan ma+,( (e da%am '%a+ma dan den.an m,da-
+e(a%* %ar,t d* +ana7 Da%am bent,( *&n b*(arb&nat d*ba1a &%e- dara- dar*
+e%,r,- jar*n.an men,j, 'ar,>'ar, ,nt,( d*b,an. d* &r.an *n* me%a%,* ,dara
8an. d*-emb,+(an (e%,ar (,dara e(+'*ra+*) (e %*n.(,n.an7 Den.an dem*(*an2
ber%a1anan den.an &(+*.en2 CO3 d**(at &%e- +e% dara- mera- dan +eba.*an be+ar
d*,ba- &%e- +e% *n* menjad* *&n b*(arb&nat 8an. %ar,t da%am '%a+ma dan
d*%e'a+(an da%am 'ar,>'ar,7
3
Karb&n m&n&(+*da (CO) men.*(at -eme 8an. ter+end*r* den.an
(e(,atan 3#7!!! (a%* %eb*- be+ar dar*'ada (e(,atan *(atan &(+*.en7 Atm&+:er
,dara men.and,n. CO da%am j,m%a- ren*(2 dan (atab&%*+me -eme 8an. n&rma%
a(an membent,( +end*r* +ej,m%a- (e;*% CO7 G,.,+ -eme 8an. terda'at 'ada
m*&.%&b*n2 -em&.%&b*n2 dan ban8a( 'r&te*n -eme 8an. %a*n terd*r* dar* +tr,(t,r
;*n;*n &r.an*( 8an. (&m'%e(+2 'r&t&'&r:*r*n2 8an. men.*(at +,at, at&m be+*
da%am bent,( :er& <e (II)7 At&m be+* mem',n8a* enam *(atan (&&rd*na+*2 em'at
men.*(at m&%e(,% '&r:*r*n 8an. datar dan 8an. d,a %a.* te.a( %,r,+ 'ada b*dan.
*n*7 Pada m*&.%&b*n dan -em&.%&b*n +a%a- +at, *(atan *n* d**+* &%e- at&m
n*tr&.en dan re+*d, -*+t*d*n7 I(atan 8an. %a*n @terb,(aA dan ber:,n.+* +eba.a*
+*+* 'en.*(atan ba.* &(+*.en7 Pada -em&.%&b*n (arb&n m&n&&(+*da (CO) da'at
ber+a*n. den.an O3 ,nt,( men.*(at ba.*an9*(atan 8an. (&+&n. ter+eb,t7 Karb&n
m&n&&(+*da ter*(at (*ra>(*ra 3!! (a%* %eb*- (,at d*band*n.(an den.an O37 Pada
(era;,nan (arb&n m&n&&(+*da2 ban8a( -em&.%&b*n 8an. berada da%am bent,(
(arb&n m&n&&(+*da -em&.%&b*n2 +e-*n..a men8ebab(an -ambatan tran+'&rt (e
jar*n.an7
5
Hem&.%&b*n mer,'a(an 'r&te*n 8an. terda'at da%am +e% dara- mera-
(SDM) dan ber:,n.+* antara %a*n ,nt,( :
7 Men.*(at dan memba1a &(+*.en dar* 'ar,>'ar, (e +e%,r,- t,b,- jar*n.an
t,b,-7
37 Men.*(at dan memba1a (arb&n d*&(+*da dar* +e%,r,- jar*n.an t,b,- (e
'ar,>'ar,7
57 Member* 1arna mera- 'ada dara-7
"7 Mem'erta-an(an (e+e*mban.an a+am>a+am dar* t,b,-7
Hem&.%&b*n mer,'a(an 'r&te*n tetramer (&m'a( 8an. +et*a'
m&n&mern8a ter*(at 'ada .,.,+ 'r&+tet*( -em dan (e+e%,r,-ann8a
mem',n8a* berat m&%e(,% $"2"#! Da%t&n7 Dara- men.and,n. B26 +am'a* 23
mM&% -em&.%&b*n m&n&mer9L (32$ C 62" .r9dL)7 Ter.ant,n. 'ada jen*+
(e%am*n dan ,m,r *nd*/*d,7
Hem&.%&b*n da'at men.*(at " at&m &(+*.en 'er tetramer (+at, 'ada
t*a' +,b,n*t -em)2 at&m &(+*.en ter*(at 'ada at&m <e
3>
2 8an. terda'at 'ada
-em2 &(+*.en d*+eb,t hemoglobin teroksigenasi ata, oksihemoglobin (HbO3)2
+edan.(an -em&.%&b*n 8an. +,da- me%e'a+(an &(+*.en d*+eb,t
de&(+*-em&.%&b*n (Hb)7

S,mber: T-e O'en D&&r Deb S*te IB B*&%&.8 Haem&.%&b*n2 3!!3
Hem&.%&b*n da'at men.*(at +,at, .a+ -a+*% 'emba(aran 8an. t*da(
+em',rna 8a*t, (arb&n m&n&(+*da (CO) dan d*+eb,t
(arbam&n&&(+*da-em&.%&b*n (HbCO)7 Ga+ CO 8an. bera+a% dar* 'r&+e+
'emba(aran 8an. t*da( +em',rna da'at men.*(at Hb membent,( HbCO7
HbO3 = CO HbCO = O3
I(atan Hb den.an CO *n* 3!! (a%* %eb*- (,at dar*'ada *(atan Hb
den.an &(+*.en2 dan a(*batn8a Hb t*da( da'at %a.* men.*(at2 memba1a dan
mend*+tr*b,+*(an &(+*.en (e jar*n.an7 Da%am (eadaan *n*2 m,atan <e 8an.
terda'at 'ada ',+at -em da'at ber,ba- menjad* <e
5>
7 Ha% *n* da'at terjad*
(arena &(+*da+* &%e- +en8a1a>+en8a1a 'en.&(+*da+*7 Hem&.%&b*nn8a d*+eb,t
hemoglobin teroksidasi ata, methemoglobin (MetHb) ata, Hb(<e
5>
)7 Da%am
bent,( *n* Hb t*da( da'at men.*(at &(+*.en ata, (e-*%an.an :,n.+*n8a 8an.
amat 'ent*n.7
Bebera'a der*/at dar* -em&.%&b*n2 m*+a%n8a &(+*Hb2 Hb dan HbCO
da'at d*beda(an den.an me%a(,(an 'en.en;eran2 dan 'ada 'en.en;eran *n*
&(+*Hb ter%*-at ber1arna mera- (e(,n*n.>(,n*n.an2 Hb ber1arna mera-
(e;&(%atan dan HbCO ber1arna '*ran. (;arm*ne t*nt)7 Unt,( %eb*- je%a+ %a.*
+et*a' der*/at Hb da'at d*beda(an den.an men..,na(an +'e(tr&+(&'7
,2 Ala$ #an Bahan
A7 A%at
7 S',*t 5 ;;
37 T&rn*E,et
57 Er%enme8er
"7 Tab,n. rea(+* ,(,ran # m% +eban8a( 3 b,a-
#7 Ra( tab,n. rea(+*
$7 Send&( +'at,%a
B7 M*(r& '*'et !! F% dan !!! F%
67 K,/et
G7 S'e(tr&:&t&mer
!7 P%a(&n
7 Sentr*:,.at&r
37 E''end&r:
57 He%%&1 t*'
B7 Ba-an
7 Sam'e% dara-
37 EDTA
57 A%(&-&% B! I
"7 Ka'a+
#7 Amm&n*a !2 I
$7 S&d*,m d*t-*&n*t
,I2 Ca!a Ke!"a
7 Er%enme8er2 tab,n. +entr*:,.e2 dan b&t&% '%a(&n ber*+* EDTA d*+*a'(an7
37 Rea.en amm&n*a !2 I d*'*'et(an +eban8a( 3! m% %a%, d*ma+,((an (e
da%am Er%enme8er7
57 Dara- /ena d*amb*% +eban8a( ;; %a%, d*ma+,(an (e da%am b&t&% '%a(&n
ber*+* EDTA dan d*(&;&( -*n..a -&m&.en7
"7 Dara- 'ada b&t&% 'a%(&n ter+eb,t d*amb*% +eban8a( ! % %a%, d*ma+,((an
(eda%am Er%enme8er 8an. +,da- d**+* %ar,tan amm&n*a !2 I +eban8a( 3!
;;2 dan d*(&;&( -*n..a -&m&.en7
#7 Sete%a- *t, d*amb*% %a.* +eban8a( ! ;; ,nt,( d*+entr*:,.e +e%ama !
men*t7
$7 Sete%a- ! men*t2 d*amb*% 3 b,a- tab,n.2 tab,n. 'ertama d*'*'et(an
+eban8a( # ;; tan'a 'enamba-an d*t-*&n*t %a%, d*ba;a ab+&rban+*n8a 'ada
'anjan. .e%&mban. #"$ nm2 +eba.a* A7
B7 La%, 'ada tab,n. 8an. (ed,a d*'*'et(an %a.* +eban8a( # ;; teta'* den.an
'enamba-an d*t-*&n*t2 d*ba;a ab+&rban+*n8a den.an 'anjan. .e%&mban.
8an. +ama (#"$ nm) +eba.a* ArHb7
,II2 Ruus Pe!hi$un.an
Kadar HbCO da'at d*-*t,n. den.an r,m,+ :
HbCO J
$2!6I K
ArHb
A

N*%a* N&rma% HbCO :

CO end&.en J L I7
Bata+ t&%eran+* CO J 3I > #I7
M #I J m,%a* t*mb,% .eja%a 9 t*da( n&rma% 9 (era;,nan7
I32 Hasil P!a+$i+u
Nama 'r&band,+ : R*+d*art*
Um,r 'r&band,+ : 3! ta-,n
0en*+ (e%am*n : Perem',an
A7 Ha+*% Pen.amatan
Pemer*(+aan HbCO
Pen;am',ran %ar,tan am&n*,m !2 I den.an '%a+ma dara-
men.-a+*%(an 'er,ba-an 1arna %ar,tan menjad* (,n*n. ben*n.7

%ar,tan am&n*,m !2 I = '%a+ma dara- Tab,n.
Pen;am',ran %ar,tan am&n*,m !2 I den.an '%a+ma dara-
(em,d*an d*tamba- den.an +&d*,m d*:&+:at men.-a+*%(an 'er,ba-an
1arna %ar,tan menjad* (,n*n. ben*n.7
=
am&n*,m = '%a+ma +&d*,m d*t-*&n*t Tab,n. 3
Pemer*(+aan Hb
Tab,n. RB

ben*n. -*ja, (e(,n*n.an
Tab,n. STD
ben*n. mera- (e;&(%atan
Tab,n. SPL

ben*n. mera- (e;&(%atan a.a( m,da
Tab,n. SP

ben*n. %eb*- teran.
B7 Ha+*% Per-*t,n.an
Pemer*(+aan HbCO
A : !25!
ArHb : !25
Pemer*(+aan Hb
Ab+ B%an(& : !2!3G
Ab+ Standard: !23B"
Ab+ Sam'e% : !26$
Kadar HbCO +am'e% :
HbCO J A K $2!6 I !25! K $2!6 I J #26G I
ArHb !25
Kadar Hb +am'e% :
R,m,+ J A SPL K # .9d%
A STD
Ab+ SPL > Ab+ RB K # .9d% J !26$ > !2!3G K # .9d% J G2$ .9d%
Ab+ STD > Ab+ RB !23B" C !2!3G
32 Pebahasan
Pra(t*(,m B*&(*m*a (a%* *n* bert,j,an ,nt,( men.-*t,n. (adar HbCO
dan Hb da%am dara- 'r&band,+7 Pemer*(+aan *n* men..,na(an '%a+ma dara-
(arena dara- +ebe%,mn8a d*tamba-(an den.an EDTA (em,d*an d**n(,ba+*
+e%ama ! men*t a.ar %ar,tann8a -&m&.en7 Sete%a- *t, d*amb*% +eban8a( ! %
dan d*;am',r den.an 3! ;; %ar,tan amm&n*a !2 I7 Kem,d*an ;am',ran
ter+eb,t d*amb*% +eban8a( ! ;; dan d*+entr*:,.e 'ada (e;e'atan "!!! r'm
+e%ama ! men*t7 La%, d*.,na(an d,a tab,n. 8an. ma+*n.>ma+*n. d*'*'et(an
+eban8a( # ;; dan +a%a- +at, tab,n. d*ber* +&d*,m d*t-*&n*t +eban8a( +at,
+end&( +'at,%a7 Sete%a- *t, (ed,a tab,n. d*,(,r ab+&rban+*n8a den.an
men..,na(an +'e(tr&:&t&meter 'ada 'anjan. .e%&mban. #"$ nm7
Berda+ar(an -a+*% 'er-*t,n.an d*da'at(an ba-1a (adar HbCO
'r&band,+ #26G I7 Berda+ar(an n*%a* n&rma% (adar HbCO da%am dara- da'at
d*(eta-,* ba-1a (adar CO da%am dara- 'r&band,+ ;,(,' t*n..*2 +e-*n..a da'at
d*(ata(an t*da( n&rma% ((era;,nan) (arena n*%a*n8a M # I7 Keabn&rma%an
ter+eb,t da'at d*'en.ar,-* &%e- ban8a( :a(t&r7 Ha% ter+eb,t +e+,a* den.an
(e.*atan a(t*/*ta+ +e-ar*>-ar* 'r&band,+ 8an. +e%a%, ber'er.*an men..,na(an
+e'eda m&t&r den.an dem*(*an re+*(& ter'a'ar &%e- a+a' (na%'&t (endaraan
+ema(*n be+ar (arena .a+ (arb&n m&n&&(+*da (CO) mer,'a(an .a+ -a+*% +*+a
'emba(aran 8an. t*da( +em',rna7 Ket*(a .a+ ter+eb,t *(,t ter-*r,' ber+ama
,dara *n+'*ra+* da'at men8ebab(an .an..,an 'ada t,b,-7 Hem&.%&b*n 8an.
+e-ar,+n8a ber*(atan den.an O32 j,+tr, ter*(at den.an CO (menjad* HbCO)
(arena da8a *(at CO te-ada' -em&.%&b*n 3!! (a%* %eb*- (,at d*band*n. da8a
*(at O3 den.an Hb7 Ha% %a*n da'at ',%a (arena 'r&band,+ be%,m menda'at
a+,'an ma(anan +ebe%,m 'emer*(+aan7 Se%a*n *t,2 b*+a j,.a terjad* a(*bat
(e+a%a-aan 'ada +aat 'ra(t*(,m ((et*da(a(,ratan +'e(tr&:&t&meter (arena
be%,m d*(a%*bra+*2 (et*da(te'atan da%am 'em*'etan +e-*n..a %ar,tan 8an.
d*.,na(an ,nt,( terjad*n8a rea(+* menjad* ber%eb*- ata, (,ran. +e-*n..a rea(+*
berja%an t*da( +em',rna2 dan %a*n +eba.a*n8a)7
N*%a* n&rma% (adar Hb 'ada 1an*ta ada%a- 3>$ .9d%2 +edan.(an
berda+ar(an 'er-*t,n.an -a+*% (adar Hb 'r&band,+ -an8a G2$ .9d%7 Den.an
dem*(*an da'at d*(ata(an ba-1a (adar Hb 'r&band,+ renda- (abn&rma%) (arena
n*%a* ter+eb,t ja,- dar* bata+ ba1a-n8a 3 .9d%7
Keadaan den.an (&n+entra+* -em&.%&b*n (,ran. dar* n*%a* n&rma%
d*+eb,t anem*a7 Geja%a ,m,mn8a *a%a- ',;at 8an. m,da- d*%*-at 'ada 1aja-
'ender*ta7 Geja%a *n* a(an tam'a( %eb*- je%a+ %a.* 'ada +e%a',t %end*r dan ba.*an
da%am (e%&'a( mata7 Se%a*n *t,2 'ender*ta j,.a ter%*-at m,da- %e%a-7 Ada
bebera'a :a(t&r 'en8ebab anem*a2 antara %a*n :
7 Anem*a (arena (e;a;atan +e% dara- mera-7
37 Anem*a (arena (e(,ran.an 4at .*4*7
57 Anem*a (arena 'erdara-an7
"7 Anem*a (arena &t&*m,n7
Man*:e+ta+* (%*n*( -em&.%&b*n 8an. a(an d*ba-a+ %eb*- %anj,t (a%* *n*
ada%a- anem*a (arena (e;a;atan +e% dara- mera-7 Sedan.(an anem*a (arena
(e(,ran.an 4at .*4* ;&nt&-n8a ada%a- anem*a (arena de:*+*en+* (a%&r* dan
'r&te*n2 de:*+*en+* be+* dan a+am :&%at2 dan (arena de:*+*en+* /*tam*n B37
Ke+e%,r,-an anem*a (arena (et*adaan :a(t&r *ntr*n+*( *n* d*+eb,t anem*a
'ern*+*&+a7 Anem*a (arena 'erdara-an b*+a d*+ebab(an berba.a* -a%2 dan 8an.
+er*n. terjad* *a%a- adan8a *n:e+ta+* ;a;*n. tamban. jen*+ Ankylostoma
duodenale dan Necator americanus. Ked,an8a da'at men.a(*bat(an
'erdara-an m*(r& teta'* da%am jan.(a 1a(t, 8an. %ama -*n..a 'ada a(-*rn8a
+am'a* 'ada t*n.(at 'erdara-an +e%a',t %end*r +a%,ran ;erna7 Pender*ta 'en8a(*t
Lupus Erythemathosus mer,'a(an +a%a- +at, ;&nt&- (e(,ran.an -em&.%&b*n
(arena &t&*m,n7
"
Hem&.%&b*n mer,'a(an m&%e(,% 'r&te*n d* da%am +e% dara- mera-
8an. ber:,n.+* ,nt,( memba1a &(+*.en dar* 'ar,>'ar, (e jar*n.an badan dan
memba1a (arb&n d*&(+*da dar* jar*n.an badan (e 'ar,>'ar, ,nt,( d*(e%,ar(an7
Nat be+* da%am bent,( <e=3 da%am -em&.%&b*n member*(an 1arna mera- 'ada
dara-7 Da%am (eadaan n&rma% !! m% dara- men.and,n. # .ram -em&.%&b*n
8an. mam', men.an.(,t !7!5 .ram &(+*.en7
#

Str,(t,r 5D Hem&.%&b*n
S,mber: D*(*'ed*a2 T-e :ree en;8;%&'ed*a2 3!!#
Hem&.%&b*n mer,'a(an +en8a1a 'r&te*n -eme 8an. men.and,n.
<e
=3
7 Hem&.%&b*n ber:,n.+* men.an.(,t &(+*.en dar* 'ar,>'ar, (e jar*n.an
t,b,- 8an. %a*n7 Pada Hem&.%&b*n ter+eb,t be+* ber'eran +eba.a* ',+at
'en.*(at &(+*.en7 Me+(*',n 'r&te*n -eme t*da( mam', men.*(at &(+*.en2 <e
=3
mem',n8a* (e;ender,n.an ;,(,' be+ar ,nt,( men.*(at &(+*.en +e-*n..a
'en.an.(,tan &(+*.en da%am t,b,- (*ta da'at berja%an7
$
Da%am 'embent,(an -em&.%&b*n d*'er%,(an 4at be+*7 Nat be+*
mer,'a(an +a%a- +at, (&m'&nen 'en8,+,n -em&.%&b*n7 0*(a t,b,- (e(,ran.an
4at be+* (de:*+*en+* 4at be+*)2 ma(a a(an men.-ambat 'embent,(an -em&.%&b*n
8an. bera(*bat 'ada ter-ambatn8a 'embent,(an +e% dara- mera-7 Se%anj,tn8a
t*mb,%%a- anem*a a(*bat (e(,ran.an 4at be+* 8an. d*+eb,t den.an anem*a
de:*+*en+* 4at be+*7
B
Terda'at bebera'a ;ara ,nt,( men.,(,r (and,n.an -em&.%&b*n da%am
dara-2 (eban8a(ann8a d*%a(,(an +e;ara a,t&mat*( &%e- me+*n 8an. d*re(a
(-,+,+ ,nt,( memb,at bebera'a ,j*an ter-ada' dara-7 D* da%am me+*n *n*2 +e%
dara- mera- d*%e'a+(an ,nt,( men.a+*n.(an -em&.%&b*n da%am bent,( %ar,tan7
Hem&.%&b*n 8an. terbeba+ *n* d*;am',r den.an ba-an (*m*a 8an.
men.and,n.* ;8an*de 8an. men.*(at (,at den.an m&%e(,% -em&.%&b*n ,nt,(
membent,( ;8anmet-em&.%&b*n7 Den.an men8*nar(an ;a-a8a me%a%,* %ar,tan
;8anmet-em&.%&b*n dan men.,(,r j,m%a- ;a-a8a 8an. d*+era' ((-,+,+n8a
ba.* .e%&mban. antara #"! nan&meter)2 j,m%a- -em&.%&b*n da'at d*tent,(an7
#
N*%a* Hem&.%&b*n b*a+an8a d*tent,(an +eba.a* j,m%a- -em&.%&b*n
da%am .ram (.m) ba.* +et*a' de(a%*ter (!! m*%*%*ter)7 N*%a* -em&.%&b*n n&rma%
ber.ant,n. (e'ada ,+*a2 a1a% remaja2 dan jen*+ (e%am*n +e+e&ran. *t,7 N*%a*
n&rma% -em&.%&b*n ada%a- :
Bar, %a-*r : B>33 .9d%
U+*a +em*n.., : #>3! .9d%
U+*a +eb,%an : ># .9d%
Kana(>(ana( : >5 .9d%
Le%a(* de1a+a : ">6 .9d%
Dan*ta de1a+a : 3>$ .9d%
Le%a(* +e'ar,- ,+*a : 37">"7G .9d%
Dan*ta +e'ar,- ,+*a : 7B>576 .9d%7
N*%a* -em&.%&b*n 8an. renda- mer,'a(an +at, (eadaan 8an. d*(ena%*
+eba.a* anem*a7 Terda'at bebera'a +ebab ber%a(,n8a anem*a7 Sebab ,tama
b*a+an8a (e-*%an.an dara- ((e;ederaan2 'embeda-an2 'endara-an (an(er (&%&n
b%eed*n.)2 (e(,ran.an /*tam*n (be+*2 /*tam*n B32 :&%ate)2 ma+a%a- +,m+,m
t,%an. ('en..ant*an +,m>+,m t,%an. &%e- bara-2 'emendaman &%e- ra1atan
dada- ;-em&t-era'82 (e.a.a%an .*nja%2 dan -em&.%&b*n t*da( n&rma% (anem*a
+e% +ab*t)7
#
Hem&.%&b*n men.*(at O3 ,nt,( membent,( &(+*-em&.%&b*n2 O3
menem'e% 'ada <e
3=
da%am -eme7 A:*n*ta+ -em&.%&b*n ter-ada' O3 d*'en.ar,-*
&%e- 'H2 +,-,2 dan (&n+entra+* 325>d*:&+:&.%*+erat (325>DPG) da%am +e% dara-
mera-7 325>DPG dan H
=
ber(&m'et*+* den.an O3 ,nt,( ber*(atan den.an
-em&.%&b*n tan'a &(+*.en2 +e-*n..a men,r,n(an a:*n*ta+ -em&.%&b*n ter-ada'
O3 den.an men..e+er '&+*+* " ranta* 'e't*da (+t,(t,r (,artener)7
Da%am (eadaan b*a+a2 man,+*a memb,t,-(an +e(*tar 5!! ;; &(+*.en
+e-ar* (3" jam) ata, +e(*tar !2# ;; t*a' men*t7 Keb,t,-an ter+eb,t berband*n.
%,r,+ den.an /&%,me ,dara *n+'*ra+* dan e(+'*ra+* b*a+a (e;,a%* da%am (eadaan
tertent, +aat (&n+entra+* &(+*.en ,dara *n+'*ra+* ber(,ran. ata, (arena +ebab
%a*n2 m*+a%n8a (&n+entra+* -em&.%&b*n dara- ber(,ran.7
O(+*.en 8an. d*b,t,-(an berd*:,+* ma+,( (e dara- da%am (a'*%er
dara- 8an. men8e%,b,n.* a%/e&%,+7 Se%anj,tn8a2 +eba.*an be+ar &(+*.en d**(at
&%e- 4at 1arna dara- ata, '*.men dara- (-em&.%&b*n) ,nt,( d*an.(,t (e +e%>+e%
jar*n.an t,b,-7 Hem&.%&b*n 8an. terda'at da%am b,t*r dara- mera- ata,
er*tr&+*t *n* ter+,+,n &%e- +en8a1a -em*n ata, -emat*n 8an. men.and,n. ,n+,r
be+* dan .%&b*n 8an. ber,'a 'r&te*n7
0,m%a- &(+*.en 8an. d*amb*% me%a%,* ,dara 'erna'a+an ter.ant,n.
'ada (eb,t,-an dan -a% ter+eb,t b*a+an8a d*'en.ar,-* &%e- jen*+ 'e(erjaan2
,(,ran t,b,-2 +erta j,m%a- ma,',n jen*+ ba-an ma(anan 8an. d*ma(an7
Pe(erja>'e(erja berat terma+,( at%*t %eb*- ban8a( memb,t,-(an &(+*.en
d*band*n. 'e(erja r*n.an7 Dem*(*an j,.a +e+e&ran. 8an. mem*%*(* ,(,ran
t,b,- %eb*- be+ar den.an +end*r*n8a memb,t,-(an &(+*.en %eb*- ban8a(7
Se%anj,tn8a2 +e+e&ran. 8an. mem*%*(* (eb*a+aan mema(an %eb*- ban8a( da.*n.
a(an memb,t,-(an %eb*- ban8a( &(+*.en dar*'ada +e&ran. /e.etar*an7
6
Ke%a*nan (arena j,m%a- (adar HbCO %eb*- dar* n&rma%2 *n* da'at
men.a(*bat(an (emat*an7 Kemat*an 'ada a+:*(+*a d*+ebab(an &%e- (arena
'en,r,nan (adar O3 da%am dara- dan jar*n.an *(at d*mana (adarn8a t,r,n
d*ba1a- (adar 8an. d*'er%,(an ,nt,( 'eme%*-araan (e-*d,'an7 Da'at d*+eb,t
j,.a an&(+*a9-*'&(+*a7 Ber(,ran.n8a ba-an 8an. memba1a &(+*.en dara-
da'at d*+ebab(an &%e- anem*a berat dan *nt&(+*:*(a+* (arb&n m&n&(+*da7
G
Ga+ (arb&n m&n&(+*da d*-a+*%(an &%e- 'emba(aran 8an. t*da(
+em',rna dar* ba-an>ba-an 8an. men.and,n. (arb&n (m*+a%n8a me+*n
(endaraan berm&t&r)2 dan da'at j,.a mer,'a(an em*+* dar* a%at 'emba(ar
(m*+a%nn8a a%at 'eman..an. +ate)7 Se%a*n *t,2 met*%en (%&r*da 8an. d*.,na(an
+eba.a* 'e%ar,t2 da%am t,b,- d*(&n/er+* menjad* (arb&n m&n&(+*da7 Karb&n
m&n&(+*da j,.a d*.,na(an ,nt,( memadam(an (eba(aran2 'emb,atan baja2
dan j,.a terda'at da%am %&r&n.>%&r&n. 'ertamban.an7 BP ata, bata+ 'a'aran
da%am %*n.(,n.an *nd,+tr* 5# ''m7
!
Kera;,nan da'at terjad* me%a%,* *n-a%a+* .a+ (arb&n m&n&(+*da ata,
,a' met*%en (%&r*da2 dan j,.a (era;,nan met*%en (%&r*da me%a%,* m,%,t7 A(*bat
(era;,nan (arb&n m&n&(+*da 8an. ,tama ada%a- +e+a( na:a+ (d*+'nea)7
Ab+&r'+* .a+ (arb&n m&n&(+*da dan .eja%a (%*n*+ 8an. t*mb,% ter.ant,n. 'ada
(adar .a+ da%am ,dara 8an. d*-*r,'2 jan.(a 1a(t, men.-*r,'2 dan (e.*atan
8an. d*%a(,(an7 0*(a (adar (arb&n m&n&(+*da !! ''m dan d*-*r,' da%am
1a(t, 6 jam2 m,n.(*n be%,m t*mb,% .eja%a (era;,nan7 Kadar (arb&n
m&n&(+*da #!! ''m 8an. d*-*r,' &%e- +e+e&ran. 8an. be(erja r*n.an da%am
1a(t, jam2 a(an men8ebab(an +a(*t (e'a%a dan na:a+ 'ende(7 Sedan.(an
j*(a (adar (arb&n m&n&(+*da 8an. %eb*- dar* !!! ''m a(an men8ebab(an
t*da( +adar2 .a.a% 'erna:a+an2 dan (emat*an j*(a d*-*r,' %eb*- dar* jam7
Geja%a (era;,nan .a+ (arb&n m&n&(+*da 8an. t*mb,% antara %a*n +a(*t
(e'a%a2 badan menjad* %ema-2 'en.%*-atan (ab,r2 m,a%2 m,nta-2 +e%a',t %end*r
ber1arna mera-2 (e;e'atan na:a+ dan ',%+a men*n.(at2 (&n/,%+*2 (&ma
+e%anj,tn8a +8&(2 de're+* na:a+2 ar*tm*a dan (emat*an7 K&m'%*(a+* 8an. da'at
terjad* antara %a*n edema ;erebra% dan 'ar,2 m*&(ard*a% *n:ar( ata, +tr&(e 'ada
'ender*ta 'en8a(*t (ard*&/a+(,%er2 .an..,an menta%2 dan (emer&+&tan
'er+&na%*ta+7 Kera;,nan (r&n*( da%am art* terjad* a(,m,%a+* .a+ (arb&n
m&n&(+*da da%am t,b,- t*da( terjad*7
!
Pen8a(*t 8an. t*mb,% a(*bat adan8a (e%a*nan 'ada -em&.%&b*n antara
%a*n :
7 Anem*a
Keadaan anem*a 8an. +er*n. d*tem,(an ('en,r,nan j,m%a- +e% dara-
mera- ata, -em&.%&b*n da%am dara-) terjad* a(*bat .an..,an +*nte+*+
-em&.%&b*n ata, .an..,an 'r&d,(+* er*tr&+*t7 D*a.n&+*+ anem*a d*m,%a*
den.an 'en.,(,ran +'e(tr,m (adar -em&.%&b*n dara-7 Pen8a(*t
t-a%a+em*a dan 'ema(a*nan 'e%a;a( DNA ,nt,( mene.a((an
d*a.n&+an8a7
37 Hem&.%&b*n&'at*
M,ta+* da%am re+*d, tertent, 8an. menent,(an da%am -em&.%&b*n
memba1a (&n+e(,en+* 8an. +er*,+2 nam,n m,ta+* 'ada ban8a( re+*d,
'erm,(aan 8an. +,da- ter%e'a+ ja,- dar* tem'at 'en.*(atan -eme t*da(
a(an men*mb,%(an (e%a*nan (%*n*(7 Sa%a- +at, 'en.e;,a%*an 8a*t, anem*a
+e% +ab*t (+*;(%e +e% anem*a) d*mana +em,a (e%,-an dan .eja%a (m*+a%n8a
(r*+*+ +e% +ab*t2 tr&mb&+*+) t*mb,% dar* m,ta+* re+*d, '&%ar t,n..a% menjad*
re+*d, n&n '&%ar7
57 Hem&.%&b*n ter.%*(&+*%a+*
Hem&.%&b*n a(an men.a%am* .%*(&+*%a+* n&n en4*mat*( (a%a, .%,(&+a
dara- ma+,( (e da%am er*tr&+*t dan .,.,+ -*dr&(d+*% an&mer*(n8a
mer,'a(an der*/at .,.,+ am*n& 8an. terda'at 'ada re+*d, %*+*% dan 'ada
,j,n. term*na% a+am am*n&7
3I2 Kesi*ulan
7 Berda+ar(an -a+*% 'ra(t*(,m dan 'emba-a+an d*(eta-,* ba-1a :
a7 Kadar HbCO 'r&band,+ J #26G I (t*da( n&rma%) (arena (adarn8a
me%eb*-* (adar n&rma% M #I7
b7 N*%a* Hb 'r&band,+ J G2$ .9d% (abn&rma%) (arena n*%a* ter+eb,t
(,ran. dar* n*%a* n&rma% 'ada 1an*ta 3>$ .9d%7
37 A:*n*ta+ Hb ter-ada' CO %eb*- (,at 3!! (a%* d*band*n.(an ter-ada' O3
ma(a da'at men*mb,%(an (eadaan 'at&%&.*+ b*%a (adarn8a d*ata+ n&rma%7
57 Abn&rma%*ta+ (adar Hb da'at men8ebab(an anem*a2 -em&.%&b*n&'at*2 dan
-em&.%&b*n ter.%*(&+*%a+*7
"7 Abn&rma%*ta+ (adar HbCO da'at men8ebab(an a+:*(+*a9an&(+*a9-*'&(+*a7
DA4TAR PUSTAKA
7 D*%%*am <7 Gan&n.7 S*r(,%a+* Ca*ran T,b,-7 3!
t-
ed7 Da%am: Buku
Ajar Fisiologi Kedokteran7 0a(arta: EGC2 GGB: #57
37 M&-ammad Sad*(*n2 DS;7 Se% Dara- Mera-7 Da%am: Biokimia
Darah7 0a(arta: D*d8a Med*(a2 3!!: ">B7
57 A%bert L7 Le-n*n.er7 G%&b,%ar Pr&te*n: Str,(t,r dan <,n.+*
Hem&.%&b*n7 Da%am: Dasar-Dasar Biokimia ilid !7 0a(arta: Penerb*t Er%an..a2
G63: G#7
"7 M&-amad Sad*(*n7 Anem*a7 Da%am: Biokimia Darah7
t-
ed7
0a(arta: D*d8a Med*(a7 3!!3: 3#>5G7
#7 D*(*7 "emoglobin2 O;*ted 3!!"2 +;reenP7 A/a*%ab%e :r&m : URL :
-tt'9911171*(*'ed*a7&r.7 A;;e++ed O;t&ber 32 3!!#7
$7 K&m'a+7 Kesehatan# 3!!3 O(t&ber7 A/a*%ab%e :r&m : URL :
-tt'991117(&m'a+7;&m7 A;;e++ed O;t&ber 32 3!!#7
B7 Med*;a+t&re7 $enyakit "emoglobin c2 O;*ted 3!!"2 +;reenP7
A/a*%ab%e :r&m : URL : -tt'991117med*;a+t&re7;&m7 A;;e++ed O;t&ber 32 3!!#7
67 D*%%*am <7 Gan&n.7 S*r(,%a+* Ca*ran T,b,-. 3!
t-
ed7 Da%am: Buku
Ajar Fisiologi Kedokteran7 0a(arta: EGC2 GGG : #B>3!7
G7 Bamban. E7 P,trant&7 Ke%a*nan Me(an*+2 A+:*(+*a2 Em:*+ema2
Ten..e%am7 Da%am: $atologi %aluran Na&as7 Semaran.: Un*/er+*ta+ D*'&ne.&r&2
3!!: "B7
!7 Sart&n&7 Penan..,%an.an Kera;,nan7 Da%am: 'acun dan
Keracunan7
t-
ed7 0a(arta: D*d8a Med*(a7 3!!3: G">67
LAMPIRAN
7 Ba.a*mana 'r&+e+ terjad*n8a (era;,nan COQ
37 Ba.a*mana .eja%a (%*n*+ (era;,nan COQ
0a1ab:
7 Ga+ (arb&n m&n&&(+*da (CO) mer,'a(an .a+ -a+*% +*+a 'emba(aran 8an. t*da(
+em',rna7 Ket*(a .a+ ter+eb,t *(,t ter-*r,' ber+ama ,dara *n+'*ra+* da'at
men8ebab(an .an..,an 'ada t,b,-7 Hem&.%&b*n 8an. +e-ar,+n8a ber*(atan
den.an O32 j,+tr, ter*(at den.an CO (menjad* HbCO) (arena da8a *(at CO
te-ada' -em&.%&b*n 3!! (a%* %eb*- (,at d*band*n. da8a *(at O3 den.an Hb7
O(+*.en menjad* t*da( b*+a d*d*+tr*b,+*(an (e jar*n.an2 a(*batn8a +e%>+e% t,b,-
t*da( da'at me%a(,(an metab&%*+me dan t*mb,%a- (er,+a(an>(er,+a(an 'ada
jar*n.an7 C&nt&-n8a 'ada (a+,+ a+:*(+*a9an&(+*a9-*'&(+*a7
HbO3 = CO HbCO = O3
37 Geja%a (%*n*+ (era;,nan CO:
S*+tem 'erna'a+an Ta(*'neaR men,r,n8a /&%,me t*da%R d*+'neaR
men.,a'R men..,na(an &t&t>&t&t 'erna'a+an
tamba-anR %,ban. -*d,n. me%ebar7
S*+tem +ara: ',+at +a(*t (e'a%a2 (e(a;a,an menta%2 t*n.(a- %a(, 8an.
ane-2 .e%*+a-2 e(+'re+* 1aja- ;ema+2 ber(er*n.at7
S*+tem (ard*&/a+(,%ar m,%a>m,%a ta(*(ard*a2 (em,d*an bra(*(ard*a
j*(a &t&t jant,n. t*da( ;,(,' menda'at &(+*.enR
'en*n.(atan te(anan dara- 8an. d**(,t* den.an
'en,r,nan te(anan dara-R ar*tm*a7
K,%*t +*an&+*+ 'ada b*b*r2 m,(&+a m,%,t2 dan da+ar (,(,7