Pemeriksaan Leukosit Esterase pada Cairan Asites untuk Deteksi Dini Peritonitis Bakterial Spontan pada Sirosis Hati
Keywords:
Leukosit esterase, Deteksi Dini, Sirosis Hati, Peritonitis bakterial spontanAbstract
Abstract
Introduction: Spontaneous Bacterial Peritonitis (SBP) is a frequent complication in liver cirrhosis with ascites patients. PBS is often without symptoms, so diagnosis is often delayed. Ascites fluid analysis is expensive, while the ascites fluid culture, as the gold standard, takes a long time and is expensive too. In addition, not all hospitals have the facilities to do both tests. Leukocyte esterase strip dye test, that was originally developed to detect the presence of polymorphonuclear cells in the urine, was also sensitive and accurate for detecting the presence of polymorphonuclear cells in the ascites fluid. This examination is easy and quick to do, and very cheap, so it can be used for early detection of SBP. Objective: To determine the sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of dye strip Leukocyte esterase test for early detection of SBP in liver cirrhosis with ascites patients. Methods: This study used a dye strip leukocyte esterase (Combur10 Test®M) on 28 samples of ascites fluid and compared with the results of ascites fluid culture. Results: The ability of leukocyte esterase test as a diagnostic test is very good at the cut-off +2 with 94.1% specificity, 63.6% sensitivity, 35% PPV and 80% NPV. Conclusion: Examination leukocyte esterase in the ascites fluid could be used for early detection of SBP in liver cirrhosis with ascites patients and could help to exclude SBP.
Keyword: Leukocyte Esterase, Early Detection, Liver Cirrhosis, Spontaneous Bacterial Peritonitis.
Abstrak
Pendahuluan: Peritonitis bakterial spontan (PBS) adalah komplikasi yang sering terjadi pada pasien sirosis hati dengan asites. PBS sering tanpa gejala sehingga diagnosa sering terlambat. Pemeriksaan analisa cairan asites mahal, sedangkan kultur cairan asites sebagai gold standard membutuhkan waktu lama dan harga mahal. Selain itu tidak semua rumah sakit memiliki fasilitas untuk melakukan ke dua pemeriksaan tersebut. Pemeriksaan carik celup Leukosit esterase yang awalnya dikembangkan untuk mendeteksi adanya sel polimorfonuklear dalam urine ternyata juga sensitive dan akurat untuk mendeteksi adanya sel polimorfonuklear didalam cairan asites. Pemeriksaan ini mudah dan cepat dilakukan serta sangat murah, sehingga dapat dipakai untuk deteksi dini PBS. Tujuan: Untuk mengetahui sensitivitas, spesifisitas, Positive Predictive Value (PPV) dan Negative Predictive Value (NPV) dari pemeriksaan carik celup Leukosit Esterase dalam mendeteksi secara dini PBS pada pasien Sirosis Hati dengan asites. Metode: Penelitian ini menggunakan carik celup leukosit esterase(Combur10 Test®M) terhadap 28 sampel cairan asites dan dibandingkan dengan hasil pemeriksaan kultur cairan asites. Hasil: Kemampuan tes leukosit esterase sebagai uji diagnostik sangat baik pada cut-off +2 dengan spesifisitas 94,1%, sensitivitas 63.6 % , PPV 35% dan NPV 80%. Kesimpulan: Pemeriksaan leukosit esterase pada cairan asites dapat di gunakan untuk deteksi dini PBS pada pasien Sirosis Hati dengan asites dan dapat membantu menyingkirkan dugaan PBS.
Kata Kunci: Leukosit esterase, Deteksi Dini, Sirosis Hati, Peritonitis bakterial spontan
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