UNIVERSITAS AIRLANGGA



Detail Article

Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 19 / No. 1 / Published : 2012-01

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Original Article :

Neutrophils lymphocyte ratio in acute appendicitis

Author :

  1. Yanty Tandirogang*1
  2. Uleng Bahrun*2
  3. Mutmainnah*3
  1. Bag PK FK-UNHAS Makassar
  2. Bag PK FK-UNHAS Makassar
  3. Bag PK FK-UNHAS Makassar

Abstract :

Acute appendicitis is one of the acute abdominal conditions encountered in almost all hospitals in Indonesia. Acute inflammation of the appendix requiring immediate surgery to prevent complications, so it should takes several particular checking’s to support the diagnosis quickly. These are leukocytes count, especially neutrophils and lymphocytes as the sensitive marker of the inflammatory process which belong to the simple laboratory examination and can be used as a diagnostic marker of acute appendicitis as well. The inflammatory immune response can be described of the percentage of neutrophils to the lymphocytes ratio in the circulation. A retrospective study was performed on patients whom suspected for acute appendicitis those undergoing appendectomy from January 2010 - May 2011. The data were grouped according to post appendectomy diagnosis and the ratio of neutrophils / lymphocytes (NLR) compared with other parameter. The NLR in each group was compaed by one way ANOVA analyzing. A total of 59 patients were identified: 19 catarrhally, 19 phlegmonous, 10 gangrenous and 11 with perforation. Compared with other markers, NLR is much better in predicting acute appendicitis. NLR increased in all groups (mean> 7), specifically on the perforated appendicitis that is greatly increased (mean=12.273). But this was not significantly different NLR from the group (p=0,098). Based on this study it can be concluded, that NLR is the better marker for diagnosis rather than leukocyte and USG. But unfortunately, it can not be used to differentiate the grading in acute appendicitis.     Apendisitis akut merupakan salah satu keadaan nyeri perut akut yang dijumpai di penderita yang dirawat hampir di seluruh rumah sakit di Indonesia. Peradangan akut apendiks tersebut memerlukan tindakan bedah segera untuk mencegah komplikasi yang umum berbahaya, sehingga diperlukan pemeriksaan yang mendukung penetapan diagnosis dengan cepat. Nilai leukosit terutama neutrofil dan limfosit merupakan dasar pemeriksaan laboratorik, petanda tertentu yang peka pada peradangan, dan dapat digunakan sebagai alat bantu mendiagnosis apendisitis akut. Respons imun terhadap peradangan dapat digambarkan dengan angka banding persentase neutrofil terhadap besaran limfosit dalam peredaran darah. Tujuan penelitian ini adalah untuk mengetahui perbandingan rasio N/L dengan mendiagnosis penderita pascaoperasi. Penelitian dilakukan secara tinjauan ke belakang (retrospektif) dengan mengambil data penderita di Rekam Medik RSUP dr. Wahidin Sudirohusodo periode Januari 2010 – Mei  2011.  Data dikelompokkan berdasarkan diagnosis pascaoperasi dan angka banding neutrofil/limfosit (rasio N/L) dibandingkan dengan tolok ukur/penunjang diagnosis lainnya. Perbandingan rasio N/L di setiap kelompok dianalisis dengan uji ANOVA satu arah. Pada penelitian ini diperoleh 59 sampel, yang 19 berasal dari penderita dengan apendisitis kataralis, 19 flegmonosa, 10 gangrenosa dan 11 perforasi. Dibandingkan dengan tolok ukur lain (leukositosis dan USG), angka banding N/L lebih baik dalam meramalkan apendisitis akut. Angka  banding N/L meningkat di semua kelompok  (rerata >7),  khusus di apendisitis perforasi sangat meningkat  (rerata =12,273). Uji perbandingan di kelompok tidak berbeda bermakna (p=0,098). Dapat disimpulkan bahwa angka banding N/L merupakan tolok ukur yang lebih baik untuk  meramalkan apendisitis akut dibandingkan dengan leukositosis dan USG. Namun hal tersebut,  tidak dapat digunakan untuk membedakan apendisitis akut berdasarkan keparahan penyakit.

Keyword :

Neutrophils lymphocytes ratio, acute appendicitis ,


References :

Abdurachman SA,(1998) Apendisitis Akut dalam : Ilmu Penyakit Dalam Jilid II Jakarta : Balai Penerbit FKUI

Sjamsuhidajat R, Wim de Jong,(1997) Apendiks vermiformis dalam: Buku Ajar Ilmu Bedah Jakarta : EGC

Flum DR, Morris A, Koepsell T,(2001) Has Misdiagnosis of Appendicitis Decreased Over Time? USA : JAMA

Leclair SJ,(2007) Morphologic and Distributive Leukocyte Disorders in: Hematology Clinical Principles and Applications Missouri : Saunders Elsevier

Zahorec R,(2001) Ratio neutrophil to lympochyte count – rapid and simple parameter of Systemic Inflammation and Stress In Critically Ill USA : Bratisl Lek Listy





Archive Article

Cover Media Content

Volume : 19 / No. : 1 / Pub. : 2012-01
  1. Pulmonary Cryptosporidiosis In Hiv And Aids
  2. Aerob Bacteria And Antimicrobial Susceptibility
  3. Plasma Volume And Factor Viii In Cryoprecipitated
  4. Comparation Measurement Triglycerides, Glycerol Blanking And Non Glycerol Blanking In Liver Cirrhosis
  5. The Residue Of Leukocyte In Thrombocyte Concentrate
  6. Antimicrobial Sensitivity Of Blood Culture In Neonatal Sepsis
  7. Neutrophils Lymphocyte Ratio In Acute Appendicitis
  8. Curcuma Zedoaria And Morinda Citrifolia As Hepatoprotector Against Carbontetrachloride
  9. Mean Platelet Volume In Stroke
  10. Dengue Serotypes Distribution In Surabaya In The Year 2012
  11. M.tuberculosis In Innate Immunity Associated With The Receptors
  12. Ovarian Dysgerminomas Cancer
  13. Information System In Laboratory Services

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