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TES DARAH LENGKAP

Endang Martiniani
Instalasi Farmasi
RSU Dr. Soetomo, Surabaya
 Parameter
Hb
RBC
MCV
MCH
MCHC
Hct / PCV
RDW
WBC
WBC differential
Platelet
 HEMOGLOBIN (Hb)
 Kemampun eritrosit dalam membawa oksigen
 Turun pd anemia (anemia kekuranangan Fe)
hipertiroidism, cirrhosis, bleeding, hamil
 ~ derajat anemia
 Nilai berbeda pd bayi dan anak-anak
 Nilai normal : ♂ 13-18 g/dl
♀ 11,5 – 16,5 g/dl
 ↑ : polycythemia vera, COPD, CHF
 HEMOGLOBIN (Hb)

Tdr dr asam amino globin & komponen

heme yg mgd atom Fe & sel pigmen
porphyrin
↓ :
anemia, hemoglobinopaties, thalassemia
liver disease, hypothyroidism, hemorrhage
hemolytic anemia (transfusi drh yg tdk
kompatibel, obat, infectious agent, SLE,
lymphoma, Hodgkin’s disease, leukemia,
renal necrosis, CA
 KELAINAN HEMATOLOGI

Eritrosit : anemia , polisitemia

Leukosit : leukopenia, leukositosis,
leukemia, myelodysplasia syndrome
Trombosit : tromositosis, trombositopenia
Homeostasis : perdarahan , trombosis
Keganasan hematologi
 SEL DARAH MERAH / RBC
 Fungsi : transport O2 dr paru-paru ke jaringan
tubuh dan membawa CO2 dr jaringan tubuh ke
paru-paru
Penurunan :
Anemia (hemolysis, hemorrhage, diet insuff of Fe)
MM, Hodgkin’s disease, lymphoma, leukemia
Addison’s disease, SLE, kegagalan sumsum
tulang
Rheumatic fever, Endocarditis
 SEL DARAH MERAH / RBC

Peningkatan :
chronic hypoxia
polycythemia vera/myeloproliferative
disorders
Diambil dari darah vena
Nilai normal : ♂ : 4,7 – 6,1 x 106/ml
♀ : 4,2 – 5,4 x 106/ml
nilai beda pd bayi dan anak
 RED BLOOD CELL INDICES
WINTHROP INDICES
 a/ ukuran & kandungan Hb dlm suatu RBC
 u/ membedakan jenis anemia
 MCV : mean corpuscular volume
indikator ukuran RBC
 MCHC : mean corpuscular Hb conc
kons rata-rata Hb dlm RBC
 MCH : mean corpuscular Hb
berat rata-rata Hb per RBC
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KELAINAN HEMATOLOGI
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MCV ↓ MCV NORMAL MCV ↑

Iron deficiency Perdarahan Defisienci as folate atau
B12
ß thalasemia Myelodisplasia myelodisplasia
Anemia sideroblastic Anemia of chronic
disease

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 Anemia Hipokrom Mikrositer
MCV ↓ : 60-62
MCHC ↓: 20-30
Penyebab : defisiensi zat besi, thalasemia
keracunan logam berat, ACD
anemia sideroblastik

Def zat besi : Fe↓, TIBC ↑, Ferritin ↓

R/ : zat besi 6 minggu (u/ anemia), 6 bulan (u/ restorasi
penyimpanan zat besi)
Thalasemia : sickle cell
R/ transfusi
deferoksamin (bila overdosis zat besi
Anemia of Chronic Disease
Fe↓, TIBC ↓, Ferritin ↑, ESR ↑
terapi penyebab utama
Anemia Sideroblastik
herediter, keganasan, alkohol
obat (INH, kloramfenikol)
Fe ↑, TIBC normal, Ferritin ↑, eritrosit
mgk normal
 Anemia Normokrom Normositer
MCV : 82-103
MCHC : 32-36
acute blood loss, malignancy, aplastic
anemia
↓ erythropoeitin : CKD, liver disease, def
endocrine, malnutrisi
Hemolisis, ACD, hydremia pd kehamilan
• R/ tranfusi, steroid, Epo, immunosupresan
 Anemia Normokrom Makrositer
MCV : 103-160
MCHC : 32-36
Def. B12, def. asam folat, liver disease,
obat (ARV), sitostatika , anemia hemolysis
Def. B12 : R/vit B12
Def.asam folat : R/ as folat 1-5 mg po 4x1
Anemia hemolitik : R/ kortikosteroid, atasi
penyakit utama
 MCHC
↓ MCHC : satu unit vol RBC sth
disentrifuge mgd Hb kurang dr normal
(hypochromic anemia)
chronic blood loss, thalassemia, def Fe
↑ MCHC : herediter, bayi baru lahir
 LEUKOSIT
Leukopenia :
Infeksi bakteri, septisemia, infeksi virus
(hepatitis, influenza, demam dengue)
Obat (sulfa, antibiotika, sitostatika), radiasi
Anemia pernisiosa, anemia aplastik

Leukositosis :
Infeksi akut (pneumonia, meningitis, demam
rhema, sepsis), intoksikasi (uremia, asidosis,
obat), perdarahan, hemolisis
 THROMBOSIT
Trombositopenia :
Leukopenia akut, anemia aplastik,
hipersplenism, virus (dengue, HIV, hepatitis
C), obat (quinine, quinidine)

Tromobositosis :
Perdarahan kronis krn def. Fe, peny inflamasi
kronis, CA, anemia hemolitik, peny inf kronis,
myeloproliferative disease
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