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Korelasi kolestasis intrahepatik dan ekstrahepatik dengan tes fungsi hati



Abstract

Background: Newborn babies experience jaundice in about 60% to 80% of cases. Differentiating between intrahepatic and extrahepatic cholestasis may require invasive examinations such as cholangiography and liver biopsy. Liver function tests are used to diagnose early cholestasis, distinguish between intrahepatic and extrahepatic cholestasis, monitor treatment response, and predict prognosis.

Objective: To understand the relationship between liver function tests and intrahepatic and extrahepatic cholestasis.

Methods: An observational analytical study was conducted cross-sectionally, using medical records of cholestasis patients treated at RSUP Prof. Dr. I.G.N.G Ngoerah, Denpasar, from January 2015 to May 2023. The study population comprised infants aged 0-3 months with cholestasis who met the inclusion and exclusion criteria. The diagnosis of intrahepatic and extrahepatic cholestasis was confirmed by liver biopsy.

Results: Among 52 cholestasis patients, 34 had extrahepatic cholestasis (biliary atresia), and 18 had intrahepatic cholestasis. The median AST in the intrahepatic group was 231.0 [31.7 – 790.7], p-value=0.744. The median ALT in the intrahepatic group was 161.6 [10.1 – 408.1], p-value=0.46. The mean ALP in the extrahepatic group was 458.32±152.56, p-value=0.3. The median GGT in the extrahepatic group was 654 [67 – 3568], p-value=0.002. The median total bilirubin in the intrahepatic group was 9.2 [0.19 – 29.35], p-value=0.281. The median conjugated bilirubin in the extrahepatic group was 7.78 [2.07 – 22.9], p-value=0.331.

Conclusion: Laboratory results for liver function tests in patients with intrahepatic and extrahepatic cholestasis did not differ significantly except for GGT, which was higher in patients with extrahepatic cholestasis. GGT showed the best diagnostic ability compared to other liver function test results.

 

Latar belakang: Bayi baru lahir mengalami penyakit kuning sekitar 60% sampai 80%. Kesulitan dalam membedakan kolestasis intra dan ekstrahepatal memerlukan pemeriksaan invasif seperti kolangiografi dan biopsi hati. Tes fungsi hati digunakan untuk menegakkan diagnosis dini kolestasis, untuk membedakan kolestasis intra dari ekstrahepatik, untuk menindaklanjuti respon pada pengobatan, dan untuk memprediksi prognosis.

Tujuan: Mengetahui hubungan antara tes fungsi hati dengan kolestasis intrahepatik dan ekstrahepatik.

Metode : Penelitian analitik observasional dilakukan secara potong lintang, menggunakan rekam medis pasien kolestasis yang dirawat di RSUP Prof. Dr. I.G.N.G Ngoerah, Denpasar sejak Januari 2015 hingga Mei 2023. Populasi penelitian ini adalah bayi 0-3 bulan dengan kolestasis yang memenuhi kriteria inklusi dan eksklusi. Diagnosis kolestasis intrahepatik dan ekstrahepatik dikonfirmasi oleh biopsi hati.

Hasil: Pada 52 anak kolestasis, 34 anak dengan kolestasis ekstrahepatik (atresia bilier) dan 18 anak dengan kolestasis intrahepatik. Median AST pada kelompok intrahepatal 231,0 [31,7 – 790,7], nilai p=0,744. Median ALT pada intrahepatal 161,6 [10,1 – 408,1], nilai p=0,46. Rerata ALP kelompok ekstrahepatal 458,32±152,56, nilai p=0,3. Median GGT kelompok ekstrahepatal 654 [67 – 3568], nilai p=0,002. Median total bilirubin kelompok intrahepatal 9,2 [0,19 – 29,35], nilai p=0,281. Median bilirubin terkonjugasi kelompok ekstrahepatal 7,78 [2,07 – 22,9], nilai p=0,331.

Simpulan : Hasil laboratorium untuk uji fungsi hati pasien dengan kolestasis intrahepatik dan ekstrahepatik tidak berbeda secara signifikan kecuali untuk GGT yang lebih tinggi pada pasien kolestasis ekstrahepatik. GGT memiliki kemampuan diagnostik terbaik dibandingkan dengan hasil tes fungsi hati lainnya.

Keywords: Kolestasis Tes fungsi hati Atresia bilier

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How to Cite

Putra, I. G. N. S., Karyana, I. P. G., Nesa, N. N. M., & Irawan, J. (2023). Korelasi kolestasis intrahepatik dan ekstrahepatik dengan tes fungsi hati. Intisari Sains Medis, 14(2), 932–936. https://doi.org/10.15562/ism.v14i2.1788
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I Gusti Ngurah Sanjaya Putra
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I Putu Gede Karyana
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Ni Nyoman Metriani Nesa
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Jessica Irawan
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