Hubungan antara Kadar Hemoglobin dan Status Gizi pada Penderita Thalassemia-β Mayor di RSUD Al-Ihsan Provinsi Jawa Barat

Abstract

Thalassemia adalah penyakit kronik yang menyebabkan penurunan Hb karena gangguan sintesis hemoglobin akibat mutasi satu atau lebih gen globin. Thalassemia dapat menyebabkan gangguan status gizi. Status gizi penderita thalassemia dipengaruhi oleh keadaan anemia kronik, kelebihan zat besi akibat rendahnya kepatuhan minum obat kelasi besi yang rendah, usia saat terdiagnosis, kadar Hb saat akan dilakukan transfusi, nutrisi dan penyakit penyerta.  Tujuan penelitian ini mengetahui hubungan antara kadar hemoglobin dan status gizi pada penderita thalassemia-β mayor di RSUD Al Ihsan Provinsi Jawa Barat. Penelitian ini menggunakan metode analitik dengan melihat data rekam medis pasien Thalassemia-β mayor di Klinik Anak RSUD Al-Ihsan periode Maret - Juni 2020 dengan rancangan studi cross sectional. Kriteria inklusi: usia 0 - 18 tahun, terdapat data BB, TB dan Hb. Dari 92 anak yang menderita Thalassemia-β mayor terdapat 82 anak yang memenuhi kriteria inklusi, kebanyakan berusia 1 - 5 tahun (40%) dengan jenis kelamin laki-laki 43 anak dan perempuan 39 anak. Pada anak usia ≤ 5 tahun: 85%  status gizinya normal, gizi kurang 6%, perawakan normal 67%, perawakan pendek  18%, dan perawakan sangat pendek  15%. Anak usia > 5 tahun: 71% status gizinya normal,  gizi kurus 10%, sangat kurus hanya 2%, perawakan normal 35%, perawakan pendek  43%, dan perawakan sangat pendek  22%. Nilai-p BB/TB pada anak ≤ 5 tahun yaitu 0.494 dan TB/U 0.33. Pada anak usia > 5 tahun dihasilkan nilai-p IMT/U 0,595 dan TB/U 0,230. Simpulan penelitian adalah kadar hemoglobin tidak memiliki hubungan dengan status gizi pasien Thalassemia-β mayor. The Relationship between Hemoglobin Levels and Nutritional Status in Thalassemia B Major Patients in Al Ihsan Hospital West Java ProvinceThalassemia is chronic disease that causes decrease in Hb due to hemoglobin synthesis disorders. Thalassemia can cause nutritional status disorders. Factors that influence nutritional status are age at diagnosis, Hb level at the time of transfusion, chronic anemia, iron overload due to low adherence to taking iron chelating agent drugs, nutrition and comorbidities. The purpose of this study is to see the relationship between hemoglobin levels and nutritional status in thalassemia B major patients in Al Ihsan Hospital West Java province. Using the analytic method by looking at the medical record data of patients who went to the children’s clinic at Al Ihsan Hospital during the March - June 2020 period with a cross-sectional study. The inclusion criteria were children aged 0 - 18 years and there were data on body weight, height and Hb level. Of the 92 thalassemia patients, 82 met the inclusion criteria. Mostly aged 1-5 years (40%) with male 43 children and female 39 children. Children aged < 5 years: 85% normal nutritional status,  6% wasted, 67% normal stature, 18% stunted and 15% severely stunted, with p-value W/BH was 0.493 and p-value BH/A was 0.331. Children > 5 years aged: 71% normal nutritional status, 10% wasted, 2% severely wasted, 35% normal stature, 43% stunted and 22% severely stunted, with p-value BMI/A was 0.595 and p-value BH/A was 0.230. The conclusion of this study is there is no relationship between hemoglobin levels and nutritional status in thalassemia B major patients.