HUBUNGAN ANTARA JUMLAH LEUKOSIT DENGAN

KEJADIAN SYOK PADA PENDERITA DEMAM BERDARAH

DENGUE DEWASA
DI RSUP Dr.KARIADI SEMARANG
ARTIKEL KARYA TULIS ILMIAH
Diajukan untuk mmnu!i tu"a# $an m%n"ka&i &r#'aratan $a%am mnm&u!
Pr("ram Pn$i$ikan Sarjana )aku%ta# K$(ktran
O%!*
FIYYA AGILATUN N. K.
NIM : G2A003079
FAKULTAS KEDOKTERAN
U N I V E R S I T A S D I P O N E G O R O
SEMARANG
2007




The Relat!"#h$ %et&ee" Le'(!)*t# +!'"t a", Sh!)( " A,'lt Pate"t !-
De".'e /ae0!11ha.) Fe2e1 " D1. Ka1a, /!#$tal Se0a1a".
)i''a A"i%atun N. K.
+
, Mu-!%i# A. U. S(.r(.
/
H%mia )ari$a
0
ABSTRACT
Background : Knowledge of the risk factors of shock in DHF can help to
establish the proper treatment earlier. In severe shock DHFcases, leuckocyts
count increase until 1. 1!
"
or more. #eukocyts count less than $!!!%mm

&leucopenia' is also mentioned as early sighn of dengue shock syndrom. (his
study was aimed to asses relationship between leukocyts count and shock in the
adult patient in dengue haemorrhagic fever
Metode ) (his was an analytical retrospecktive research with cross sectional
approach. (his research was carried out among Dengue Haemorrhagic Fever
patients who were hospitali*ed in Dr. Kariadi Hospital +emarang during the
periode of ,uly 1
st
!!1 - ,une.!
th
!!/. +econdary data that taken from medical
report were age, se0,leukocyts count, severity of DHF,clinical sign, bleeding
manifestation, days of fever before admittance, and long stay in hospital. (he
statistical analysis used 1ann23hitney test and 4hi s5uare test with +6++ for
3indows 1$.!
Result :(otal sample included were 71 person, 18 of them developed shock.
1ann23hitney test showed there was no significant difference in leukocyts
count9s rate between DHF with shock and DHF without shock &p :!.$".' '. 4hi
s5uare test &with leukocyts count rate ;$/7.%mm
.
as shock risk factor' showed
that there was no significant relationship between leukocyts count9s rate and
shock in DHF &p: !,$$8< "$ = 4I: !,8.2 ,1.>'.
Conclusion )(here was no significant difference between leukocyts count9s rate
of DHF adult patient with shock and patient without shock.
Key wordsi ) Dengue haemorrhagic fever &DHF', shock syndrom, white blood cell
count
+
Stu$nt (. M$i-a% )a-u%t', Di&(n"(r( Uni1r#it', Smaran"
/
L-turr (. Intrna% D&artmnt, M$i-a% )a-u%t', Di&(n"(r( Uni1r#it',
Smaran"
0
L-turr (. Mi-r(2i(%("' D&artmnt, M$i-a% )a-u%t', Di&(n"(r( Uni1r#it',
Smaran"





/'%'".a" a"ta1a 3'0lah Le'(!#t ,e".a" Ke4a,a" S*!( $a,a Pe",e1ta
De0a0 5e1,a1ah De".'e De&a#a , RSUP ,1. Ka1a, Se0a1a".
)i''a A"i%atun N. K.
+
, Mu-!%i# A. U. S(.r(.
/
,H%mia )ari$a
0
A5STRAK
Lata1 %ela(a". :. Pn"na%an tr!a$a& .akt(r3.akt(r r#ik( #'(k &a$a DBD
$a&at mm2antu &nan"anan #'(k tr#2ut #-ara %2i! $ini. Pa$a #'(k 'an" 2rat
$a&at $ijum&ai %uk(#it(#i# !in""a +/.+4
5
6% atau %2i!. Luk(&ni 7 84446mm
/
ju"a $i#2utkan #2a"ai &rtan$a #'(k. Pn%itian ini 2rtujuan untuk mn"ta!ui
!u2un"an antara jum%a! %uk(#it $n"an kja$ian #'(k &a$a &n$rita $mam
2r$ara! $n"u $9a#a
Met!,e * Pn%itian ini mru&akan &n%itian ana%itik rtr(#&kti. $n"an
&n$katan -r(## #-ti(na%. Pn%itian ini $i%akukan tr!a$a& Pa#in DBD u#ia :
+; ta!un 'an" &rna! $ira9at $i RSUP Dr. Karia$i Smaran" &a$a &ri($ + Ju%i
/44+ !in""a 04 Juni /44<. Data #kun$r 2ru&a umur, jni# k%amin, jum%a!
%uk(#it, $rajat DBD, "ja%a k%ini#, tan$a3tan$a &r$ara!an, %ama $mam
#2%um $ira9at, ma#a ra9at $i$a&atkan $ari -atatan m$ik Ana%i#a #tati#tik
mn""unakan uji 1ann23hitney $an uji 4hi s5uare &r("ram +6++ for 3indows
1$.!
/a#l * T(ta% #am&% $i&r(%! /=+ (ran" &n$rita DBD $n"an +; (ran"
$iantaran'a mn"a%ami "ja%a #'(k. Uji 1ann23hitney rata3rata jum%a! %uk(#it
ti$ak tr$a&at &r2$aan 2rmakna antara &n$rita DBD ti$ak #'(k $an
&n$rita $n"an #'(k >p? 4,850@. Pa$a uji 4hi s5uare >$n"an rata3rata jum%a!
%uk(#it 7 8<=0 #2a"ai .akt(r r#ik( #'(k@ ti$ak tr$a&at !u2un"an 2rmakna
antara rata3rata jum%a! %uk(#it &n$rita DBD $n"an kja$ian #'(k >p?4,88;A
58 B CI 4,/;03 /,+0D@.
Ke#0$'la" * Ti$ak tr$a&at &r2$aan 2rmakna antara rata3rata jum%a! %uk(#it
&n$rita DBD $9a#a $n"an kja$ian #'(k $an &n$rita $n"an kja$ian #'(k.
Kata ('") * DBD, kja$ian #'(k, jum%a! %uk(#it
+
Ma!a#i#9a )aku%ta# K$(ktran Uni1r#ita# Di&(n"(r( Smaran"
/
Sta. &n"ajar 2a"ian I%mu &n'akit $a%am )aku%ta# K$(ktran Uni1r#ita#
Di&(n"(r( Smaran"
0
Sta. &n"ajar 2a"ian Mikr(2i(%("i )aku%ta# K$(ktran Uni1r#ita# Di&(n"(r(
Smaran"




/ALAMAN PENGESA/AN
Kar'a Tu%i# I%mia!
/'%'".a" a"ta1a Pe1'%aha" 3'0lah Le'(!#t ,e".a" Ke4a,a" S*!(
$a,a Pe",e1ta De0a0 5e1,a1ah De".'e De&a#a , RSUP D1. Ka1a,
Se0a1a".
Di#u#un (%!*
Nama * )i''a A"i%atun N. K.
NIM * G/A 440 4=5
Diajukan untuk mmnu!i tu"a# $an m%n"ka&i #'arat $a%am mnm&u!
Pr("ram Pn$i$ikan Sarjana
Smaran", A"u#tu# /44=
Ktua Pn"uji
Dr.$r. Su&ri!ati, MS-,S&.THT
NIP. +04<48=/+
Pn"uji Pm2im2in"
$r. Bantn" H. W. S&.PD $r. Mu-!%i# A-!#an Uj$i S.,S&.PD
NIP. +;4+;<5;/ NIP. +;4 /0= 8+8




ENDA/ULUAN
Dmam 2r$ara! $n"u 6 DBD >dengue haemorrhagic fever 6 DHF @
a$a%a! #uatu &n'akit in.k#i 'an" $i#2a2kan (%! 1iru# $n"u m%a%ui 1kt(r
n'amuk "nu# A$# > trutama ?. aegypti $an ?. albopictus@.
+,/,0,;
DBD
mmi%iki m&at "ja%a utama 'aitu $mam tin""i, mani.#ta#i &r$ara!an,
!&at(m"a%i, $an k"a"a%an #irku%a#i >#'(k@. Bi%a $i2an$in"kan $n"an Dmam
Dn"u, DBD mmi%iki "ja%a k!a# 'aitu k%ainan !m(#ta#i# $an &rm2#an
&%a#ma 'an" $itan$ai $n"an a$an'a tr(m2(#it(&nia $an !m(k(n#ntra#i.
+,/,8,<,=
Jum%a! in#i$n DBD mn"a%ami .%uktua#i $an -n$run" mnin"kat #rta
mn'2ar k 9i%a'a! 'an" %2i! %ua#.
/,8
Pa$a ta!un +55D tr$a&at =/.+00 ka#u#
DBD $n"an +.;+; jum%a! kmatian.
8
DBD $a&at mn'ran" #mua "(%(n"an
umur trutama anak3anak. Namun, $a%am $ka$ trak!ir tr%i!at k-n$run"an
knaikan &r(&(r#i k%(m&(k $9a#a
./,D
Pa$a ka#u# DBD 'an" 2rat, k(n$i#i &a#in $a&at 2ru2a! k ara!
trja$in'a #'(k. Ha% ini umumn'a trja$i &a$a .a# kriti#.
5
Pa$a #aat #u!u turun
atau 22ra&a #aat ##u$a!n'a > !ari k30 #am&ai $n"an !ari k3=@, $a&at
$ijum&ai tan$a3tan$a k"a"a%an #irku%a#i.
/
Hi&(tn#i atau #'(k &a%in" 2an'ak
mun-u% &a$a !ari k3; #am&ai k3< $mam.
8
N'ri a2$(mina% akut #rin"ka%i
$ijum&ai #2%um trja$i #'(k. Pn$rita akan k%i!atan %ma!, "%i#a!, kaki
tan"an $in"in $an %m2a2, #ian(#i# $i #kitar mu%ut. Na$i 'an" -&at namun
%ma! $an &nurunan tkanan na$i kuran" atau #ama $n"an /4 mmH" 2ia#an'a
$ijum&ai &a$a #ta$ium a9a% #'(k. S'(k $a&at 2rkm2an" -&at mnja$i
profound shock. S'(k 'an" ti$ak #"ra $iata#i $n"an 2aik $a&at mnim2u%kan




k(m&%ika#i 2ru&a a#i$(#i# mta2(%ik, &r$ara!an #a%uran -rna !2at atau
&r$ara!an %ainn'a.
/,8,D
Dn"an $mikian, &n"na%an $ini tr!a$a& kmun"kinan
tim2u%n'a #'(k amat &ntin". Ha% ini $a&at $i%akukan $n"an mn"na%i .akt(r
a&a #aja 'an" $a&at mnja$i &r$ikt(r #'(k.
Jum%a! %uk(#it &a$a &n$rita DBD 2r1aria#i $ari %uk(&nia rin"an
!in""a %uk(#it(#i# #$an". Luk(&nia akan mun-u% antara !ari $mam k3+ $an
k30 &a$a 84 B ka#u# DBD

rin"an. Ha% ini #2a"ian 2#ar $i#2a2kan (%!
a$an'a $"nra#i #% PMN 'an" matur $an &m2ntukan #% PMN mu$a.
K(n#ntra#i "ranu%(#it mnurun antara !ari k30 $an k3D. Pa$a #'(k 'an" 2rat
$a&at $ijum&ai %uk(#it(#i# !in""a +/ E +4
5
6 %itr atau %2i! 'an" $i#rtai $n"an
nut(&nia a2#(%ut. Pa$a !ari trja$in'a #'(k atau &nurunan $mam $ari
&n$rita DBD6DSS $a&at $ijum&ai &nin"katan 'an" n'ata $ari jum%a! a2#(%ut
$an &r#nta#i %im.(#it ati&ik
=
Br$a#arkan !a% tr#2ut, maka &n%itian ini 2rtujuan untuk mn"ta!ui
!u2un"an antara &ru2a!an jum%a! %uk(#it $n"an kja$ian #'(k &a$a &n$rita
DBD $9a#a.
METODE PENELITIAN
Pn%itian ini mru&akan #tu$i cross sectional 'an" 2r#i.at rtr(#&kti..
Pn%itian ini $i%ak#anakan $i RSUP Dr. Karia$i Smaran" #jak )2ruari /44=
!in""a Juni /44=. Sum2r $ata mru&akan $ata #kun$r 'an" $ikum&u%kan $ari
$(kumn -atatan m$ik ra9at ina&. P(&u%a#i trjan"kau &n%itian a$a%a! &a#in
#-ara k%ini# $i$ia"n(#a DBD $n"an u#ia : +; ta!un 'an &rna! ra9at ina& $i




RSUP Dr. Karia$i &ri($ + ju%i /44+ F 04 Juni /44<. Sam&% a$a%a! an""(ta
&(&u%a#i trjan"kau 'an" mmi%iki $ata jum%a! %uk(#it !ari k30 $an atau k3
;,8,<,= $mam. Kritria k#k%u#i $ari #am&% a$a%a!A +@mmi%iki ri9a'at $ia"n(#a
&n'akit %ain 'an" #-ara k%ini# tr-antum &a$a -atatan m$ik 'an" $a&at
mm&n"aru!i jum%a! %uk(#it #&rti $mam ti&!(i$, ISPA, ISK, #'(k #&tik,
&'uria, tn$initi#, &n'akit kr(ni#, +teven ,ohnson +yndrom, %&t(#&ir(#i#,
k(%#i#ti# $an !&atiti# #%ama mn$rita DBD, /@ ri9a'at &m2rian tra&i (2at
k(rtik(#tr(i$ #&rti $Eamta#(n, &r$ni#(n, ka%mta#(n. S2a"ai 1aria2%
22a# a$a%a! jum%a! %uk(#it #$an"kan 1aria2% tr"antun" a$a%a! kja$ian #'(k.
Jum%a! %uk(#it $iukur mn""unakan analy*er hema.. Data 'an" $iam2i% a$a%a!
jum%a! %uk(#it !ari 03= $mam. Data tr#2ut $iu2a! mnja$i $ua k%(m&(k $ata
n(mina% 2r$a#arkan titik &(t(n" >cutoff point'. Kja$ian #'(k $itntukan
2r$a#arkan kritria 2ru&a $.ni#i ka#u# DBD $itam2a! "an""uan #irku%a#i
'an" $itan$ai $n"an na$i -&at $an %ma!, tkanan na$i mnurun > /4 mmH"
atau kuran"@ atau !i&(tn#i, &r.u#i &ri.r mnurun, ku%it $in"in $an %m2a2,
#ian(#i# #kitar mu%ut, &n$rita "%i#a! >WHO +55=@.
/
DBD $rajat I $an II
trma#uk k%(m&(k n(n #'(k #$an"kan DBD $rajat III $an IG trma#uk
k%(m&(k $n"an "ja%a #'(k. Data %ain 'an" $ikum&u%kan m%i&uti umur, jni#
k%amin, "ja%a k%ini#, tan$a3tan$a &r$ara!an, %ama $mam #2%um $ira9at,
ma#a ra9at.
Pn"(%a!an $ata $i%akukan $n"an -ara mn'untin", mn"%(m&(kkan
$ata $an ta2u%a#i $ata. Ana%i#i# $ata mn""unakan uji 4hi s5uare, uji 1ann2
3hitney &r("ram +6++ for windows 1$.!.




/ASIL
S%ama &n%itian, $i&r(%! 05= &n$rita DBD &a$a &ri($ ju%i /44+ F
04 Juni /44<. Dari jum%a! tr#2ut $iam2i% #am&% /=+ (ran" 'an" mmnu!i
kritria ink%u#i $an k#k%u#i, $imana +; >8,/B@ (ran" $iantaran'a mn$rita
#'(k.
S2an'ak /8= &n$rita DBD tan&a #'(k tr$iri $ari &n$rita %aki3%aki
#2an'ak +;; (ran" >8<B@ $an &rm&uan ++0 (ran" >;;B@. S2an'ak +;
&n$rita DBD $n"an #'(k tr$iri nam (ran" %aki3%aki >;/,5B@ $an $%a&an
(ran" &rm&uan >8=,+B@. Br$a#arkan umur, &r(&(r#i &a%in" 2an'ak &a$a u#ia
+83/4 ta!un, 'aitu #2an'ak +// (ran" >;=,8B@ &a$a &n$rita DBD tan&a #'(k
$an +4 (ran" >=+,;B@ &a$a &n$rita $n"an #'(k. Pa$a &n$rita DBD tan&a
#'(k, "ja%a k%ini# 'an" &a%in" 2an'ak mun-u% a$a%a! mua% ><=,= B@, #akit k&a%a
$an atau &u#in" k&a%a ><4,= B@, munta! >;;,; B@, n'ri &i"a#trium >04,=B@,
$an mia%"ia >+;B@, #$an"kan tan$a &r$ara!an 'an" &a%in" 2an'ak mun-u%
a$a%a! &tki >0D,5 B@. Pa$a &n$rita DBD $n"an mani.#ta#i #'(k, "ja%a
k%ini# 'an" &a%in" 2an'ak mun-u% a$a%a! mua% >=+,;B@, #akit $an atau &u#in"
k&a%a >8=,+B@, munta! >84B@, n'ri &i"a#trium08,=B@, akra% $in"in >/D,<B@,
#$an"kan tan$a &r$ara!an 'an" &a%in" 2an'ak mun-u% a$a%a! &tki >84B@.




5078.50
6168.00
5751.50
4678.30
4363.70
0
1000
2000
3000
4000
5000
6000
7000
3 4 5 6 7
Hari
L
e
u
k
o
s
i
t
Gam2ar +. Rrata jum%a! %uk(#it &n$rita ti$ak #'(k !ari k 03= $mam.
5016.00
6631.80
7040.50
5116.50
4955.00
0
1000
2000
3000
4000
5000
6000
7000
8000
3 4 5 6 7
Hari
L
e
u
k
o
s
i
t
Gam2ar /. Rrata jum%a! %uk(#it &n$rita #'(k !ari k 03= $mam.
Pa$a "am2ar + $an / $a&at $i%i!at rrata jum%a! %uk(#it trn$a! trja$i
&a$a !ari k3; $mam. Namun tr$a&at ni%ai 'an" %2i! rn$a! &a$a rrata jum%a!
%uk(#it &a$a &n$rita DBD 'an" ti$ak mn"a%ami #'(k. Smntara rrata #'(k
trja$i &a$a !ari k3;,; $mam $am &a%in" 2an'ak trja$i &a$a !ari k38 $mam
>84B@.






Ta2% +. Rrata jum%a! %uk(#it !ari k 03=$mam

Ni%ai rrata jum%a! %uk(#it &a$a &n$rita DBD $n"an #'(k a$a%a!
85<5,+ #%6mm
0
H 0+D0,0, #$an"kan &a$a &n$rita tan&a kja$ian #'(k a$a%a!
80=<,5 H //58.=. Dn"an uji 1ann23hitney rata3rata jum%a! %uk(#it !ari 03=
$mam ti$ak tr$a&at &r2$aan 2rmakna antara &n$rita DBD $n"an #'(k
$an &n$rita tan&a #'(k >& ? 4,850@.
Data jum%a! %uk(#it 'an" $i&r(%! $iu2a! mnja$i $ua k%(m&(k $ata
n(mina% 2r$a#arkan titik &(t(n". Ni%ai &r&(t(n"an $i$a&at $ari &r&(t(n"an
"ra.ik rata3rata jum%a! %uk(#it &n$rita DBD $n"an #'(k $an &n$rita tan&a
#'(k.
Ta2% /. Di#tri2u#i kja$ian #'(k 2r$a#arkan jum%a! %uk(#it mak#imum !ari 03=
Dmam
S'(k
Ya Ti$ak t(ta%
Pn$rita DBD jum%a! %uk(#it >#%6mm
0
@
Man SD M$ian

S'(k >n ? +;@ 85<5,+ 0+D0,0 8+<8,;
Ti$ak #'(k >n ? /8=@ 80=<,5 //58.= ;5+D,=




Uji 1ann23hitney A & ? 4,850
Jum%a! %uk(#it6mm
0
7 8<=0 < +0+ +0=
I 8<=0 D +/< +0;
T(ta% +; /8= /=+
J
/
? 4,084
2
A $. ? +A 58B CI ? 4,/;0 F /,+0DA p ? 4,88;
PEM5A/ASAN
Kja$ian ma#a kriti# $ari in.k#i $n"u !an'a /; F =/ jam, #an"at -&at
#%#ai $an ti$ak a$a "ja%a #i#a, maka #i.at tr#2ut miri& aki2at m$iat(r &a$a
kja$ian3kja$ian %ain, mi#a%n'a #&#i# $an #'(k. S'(k mun-u% $a%am 9aktu
#in"kat, 'aitu #kitar /;3;D jam $an &a%in" %ama =/ jam, maka $i$u"a .akt(r
m$iat(r atau #it(kin mm&un'ai &ranan 'an" 2#ar.
8

Sit(kin atau m$iat(r a$a%a! #mua &r($uk #% 'an" m%i&uti &r($uk $ari
m(n(#it, %im.(#it atau #% 'an" %ain. Nama &r($ukn'a 2rma-am3ma-am 'aitu
intr%ukin, %im.(kin,m(n(kin, TN) >tum(r n-r(#i# .akt(r@.
8,+4
Km(kin a$a%a! #it(kin 'an" 2r&ran $a%am km(tak#i# #%3#% %uk(#it
>%im.(#it,m(n(#it, $an nutr(.i%@ k tm&at in.k#i atau kru#akan jarin"an.
Sit(kin trutama $i&r($uk#i (%! m(n(#it6makr(.a" $an #%3#% %ain #&rti #%
n$(t%, tr(m2(#it, nutr(.i%, #% T, kratin(#it $an .i2r(2%a# #2a"ai r#&(n
tr!a$a& &r(## in.k#i atau kru#akan .i#ik.
+4
Br&in$a!n'a #% .a"(#it $ari 1a#ku%r k jarin"an akan mn'2a2kan
&rma2i%ita# $in$in" &m2u%u! $ara! mnin"kat #!in""a -airan 1a#ku%r 'an"
k%uar #makin 2an'ak. Ha% ini $a&at mn"aki2atkan trja$in'a #'(k. Da%am
&n%itian ini, ti$ak $i%akukan &n"amatan tr!a$a& m$iat(r atau #% .a"(#it




#&rti m(n(#it, makr(.a", $an #% PMN >nutr(.i%@. Pn"amatan $i%akukan
tr!a$a& jum%a! %uk(#it.
Dari uji 1ann23hitney tr!a$a& jum%a! %uk(#it ti$ak tr$a&at &r2$aan
2rmakna antara rata3rata jum%a! %k(#it &n$rita DBD 'an" mn"a%ami #'(k
$an &n$rita 'an" ti$ak mn"a%ami #'(k >& ? 4,850@. Dari uji 4hi s5uare
>$n"an ni%ai rata3rata jum%a! %uk(#it 78<=0 6mm
0
#2a"ai .akt(r r#ik( #'(k@
ti$ak tr$a&at !u2un"an 2rmakna antara rata3rata jum%a! %uk(#it $n"an
kja$ian #'(k >p ? 4,88;@.
Pa$a &n%itian $i In$ia, $i#2utkan 2a!9a tr$a&at &r2$aan jum%a!
%uk(#it 'an" 2rmakna >&? 4,44/@, antara &n$rita DSS >mean ;4/+ cells%cumm
H +<+D@ $n"an &n$rita DBD tan&a #'(k >mean =5;4 cells%cumm@ .
++
Ha#i%
'an" 2r2$a $n"an !a#i% &n%itian &nu%i# mun"kin karna &r2$aan #am&%.
Pnu%i# mn""unakan #am&% &n$rita $9a#a, #mntara &n%itian $i In$ia
tr#2ut mn""unakan #am&% anak3anak.
Pn%itian #2%umn'a mn'2utkan $ari +D< &n$rita in.k#i 1iru#
$n"u, $i&r(%! =+ (ran" trma#uk kritria DBD $n"an /5 (ran" $iantaran'a
trma#uk DSS > $rajat III $an IG DBD@. Ditmukan ka$ar IL3D $an %a#ta# 'an"
%2i! tin""i &a$a &n$rita $n"an #'(k $i2an$in" &n$rita tan&a #'(k #-ara
2rmakna >p74,4/@. IL3D mru&akan km(kin 'an" mm&un'ai km(atraktan
tr!a$a& nutr(.i% $an mam&u untuk mn"akti1a#i #rta mn$"ranu%a#i nutr(.i%.
E%a#ta# a$a%a! k(n#titun $ari "ranu%a aKur(.i%ik $ari nutru.i%. Sam&% &n%itian
a$a%a! anak3anak. Pn"am2i%an $ara! $i%akukan ktika &a#in ma#uk $an &a$a




22ra&a &a#in ktika $ira9at. Dari &n%itian tr#2ut $i$a&atkan k(r%a#i 'an"
%ma! antara %a#ta# $an jum%a! %uk(#it.
+/
Pn%itian $i Gitnam mn"nai #tu$i &ran .akt(r imun(%("i &a$a
&at("n#i# DBD, k!u#u#n'a DSS >dengue shock syndrom@ &a$a 04 (ran"
&n$rita $an ;0 (ran" #!at $in'atakan 2a!9a tr$a&at &nurunan $ari akti.ita#
k(m&%mn, &%at%t, $an jum%a! nutr(.i% 'an" 2rmakna >p7 4,44+@ &a$a
&n$rita $n"an DSS.
+0
Ti$ak $i%a&(rkan mn"nai &ru2a!an jum%a! %uk(#it.


KESIMPULAN
Pa$a &n$rita DBD $9a#a ti$ak tr$a&at !u2un"an 2rmakna
antara rata3rata jum%a! %uk(#it $n"an kja$ian #'(k.
SARAN
+. Untuk &n%itian #%anjutn'a $i&r%ukan &mrik#aan $.initi. DBD
untuk mn"uran"i 2ia# &n"ukuran.
/. Pa$a &n%itian 2rikutn'a &r%u &mrik#aan 1aria2% %ain #&rti
#tatu# imun &n$rita #2%um #akit,tan$a k"a"a%an #irku%a#i #&rti
a#it#, .u#i &%ura, !m(k(n#ntra#i, !itun" nutr(.i%, !itun" %im.(#it
$an m(n(#it.
0. Da%am mmantau &rkm2an"an k(n$i#i &n$rita DBD, &r%u
$i%akukan &mrik#aan !itun" jni# untuk m%i!at &ru2a!an jum%a!




nutr(.i%, %im.(#it #2a"ai in.(rma#i tam2a!an $an k9a#&a$aan
tr!a$a& kja$ian #'(k.
U+APAN TERIMA KASI/
Prtama3tama &nu%i# mmmanjatkan &uji $an #'ukur k&a$a A%%(!
Su2!ana%%a!u9ataLa%a ata# ra!mat $an !i$a'a!3N'a #!in""a &nu%i# $a&at
mn'%#aikan &n%itian kar'a i%mia! ini. K&a$a &ara &a#in DBD 'an"
mm2rikan #um2an"#i! k&a$a i%mu &n"ta!uan m%a%ui -atatan m$ikn'a,
$r. Mu-!i# A-!#an U. S., S&.PD $an $r. H%mia )ari$a, S&.A ata# 2im2in"ann'a,
$r.C!ar%# Limant(r( S&.PD ata# r1i#i 2%iau tr!a$a& &r(&(#a% &nu%i#, Sta. Su2
2a"ian Rkam M$ik RSUP Dr. Karia$i Smaran" ata# 2antuann'a $a%am
mn"um&u%kan $ata &n%itian, k&a$a (ran" tua, tman3tman, #rta #mua &i!ak
'an" t%a! mm2antu 2aik m(ra% mau&un matria%.




DAFTAR PUSTAKA
+. Su!n$r(, Nain""(%an L, C!n K, P(!an HT. Dmam 2r$ara! $n"u.
Da%am * Su$('( AW, Sti'(!a$i B, A%9i I, Sima$i2rata M, Stiati S, $it(r.
@uku aAar ilmu penyakit dalam Ailid III edisi IB. Jakarta* Pu#at Pnr2itan
D&artmn I%mu Pn'akit Da%am )aku%ta# K$(ktran Uni1r#ita#
In$(n#ia,/44<*+=0+3+=08.
/. Ha$in"(r( SRH, S("ijant( S, Wur'a$i S, Sur(#( T, $it(r. Tata%ak#ana
$mam 2r$ara! $n"u $i In$(n#ia. Jakarta* Dirkt(rat Jn$ra%
Pm2ranta#an Pn'akit Mnu%ar $an Pn'!atan Lin"kun"an, /44+
0. Kri#tina. E&i$mi(%("i $mam 2r$ara! $n"u./44;. A1ai%a2% .r(m URL*
HYPERLINK !tt& * 66 999.$ink#jatim."(.i$
;. Darm(9an$(9( W. Dmam 2r$ara! $n"u./44/. A1ai%a2% .r(m URL *
HYPERLINK !tt& 66 999.&n'akit mnu%ar.-(m.!tm
8. Sutar'(. Dn"u. Y("'akarta * M$ika .aku%ta# K$(ktran UGM, /44;
< Tum2%aka AR. Dia"n(#i# $mam $n"u6 $mam 2r$ara! $n"u.
Da%am * Ha$in"(r( SRH, Satari HI,&n'untin". Demam berdarah dengue
naskah lengkap pelatihan bagi pelatih dokter spesialis anak dan dokter
spesialis penyakit dalam dalam tatalaksana kasus D@D. Jakarta * Ba%ai
Pnr2it )KUI, +555* =83D+.
=. Jatana#nS, T!(n"-!ar(n P. Dn"u !am(rr!a"i- .1r in S(ut!3Ea#t
A#ian -(untri#. in * T!(n"-!ar(n P, -(m&i%ir. 1onograph on Dengue %
Dengue Haemor rhagic Fever. In$ia * W(r%$ Ha%t! Or"aniKati(n,+550 */03
04
D Sam#i HTK, Ru#&an$i Tri, Stia9an J, $kk. Sim&(#ium Ti"a Dka$ Dmam
Br$ara! Dn"u $i In$(n#ia. Jakarta. +55=.
5. Gu2%r DJ. Dn"u an$ $n"u !m(rr!a"i- .1r. In* C%ini-a% mi-r(2i(%("'
r1i9#. C(%(ra$(* U.S. D&artmnt (. Ha%t! an$ Human Sr1i-#,+55D *
;D43;5;
+4. Brata9i$jaja, Karnn Garna. Imun(%("( $a#ar $i#i k F <. Jakarta * Ba%ai
&nr2it )aku%ta# K$(ktran In$(n#ia, /44;
++. S!a! ira, Katira B!u#!an. C%ini-a% an$ %a2(rat(r' a2n(rma%iti# $u t(
$n"u in !(#&ita%iK$ -!i%$rn in Mum2ai in /44;. /44;. A1ai%a2% .r(m
URL * HYPERLINK
!tt&*66999.#ar(.9!(.int6Link)i%#6Dn"uMBu%%tin#MG(%um#M/5M>/448@M
CHAPTER++.&$.
+/. Ju..ri M,Gan $r Mr G.M.,Ha-k C.E.,Haa#n((t K.,Sutar'(, Grman A. J.
$kk. In.%amat(r' m$iat(r# in $n"u 1iru# in.-ti(n in -!i%$rn * Intr%ukin3
D an$ it# r%ati(n#!i& t( nutr(&!i% $"ranu%ati(n.+555. A1ai%a2% .r(m URL *
HYPERLINK !tt&*66999.&u2m$-ntra%.ni!."(16arti-%rn$r..-"iN
t((%?&u2m$O&u2m$i$?+4<05;0<
+0. P!an DT, Ha NT, T!u- LT, Dit NH, P!u LG, Nin! LY, t-. S(m -!an"# in
immunit' an$ 2%(($ r%ati(n t( -%ini-a% #tat# (. $n"u !am(rr!a"i- .1r




&atint# in 1itnam.+55+. A1ai%a2% .r(m URL * HYPERLINK
!tt&*66999.m$#-a&.-(m6m$%in6a2#tra-t6+D+008D
Tidak Syok




Frequency Ta!e
"sia
122 47.5 47.7 47.7
88 34.2 34.4 82.0
30 11.7 11.7 93.8
9 3.5 3.5 97.3
4 1.6 1.6 98.8
3 1.2 1.2 100.0
256 99.6 100.0
1 .4
257 100.0
< 21 th
21 - 30 th
31 - 40 th
41 - 50 th
51 - 60 th
> 60 th
Total
Valid
System Missin
Total
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
#ender
144 56.0 56.0 56.0
113 44.0 44.0 100.0
257 100.0 100.0
)a*i-la*i
&e"em+$an
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
La$a ina%
3 1.2 1.2 1.2
19 7.4 7.4 8.6
52 20.2 20.2 28.8
54 21.0 21.0 49.8
59 23.0 23.0 72.8
29 11.3 11.3 84.0
22 8.6 8.6 92.6
10 3.9 3.9 96.5
3 1.2 1.2 97.7
4 1.6 1.6 99.2
1 .4 .4 99.6
1 .4 .4 100.0
257 100.0 100.0
1
2
3
4
5
6
7
8
9
10
11
14
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent




La$a de$a$ see!u$ dira&at
2 .8 .8 .8
20 7.8 8.1 8.9
58 22.6 23.4 32.3
73 28.4 29.4 61.7
62 24.1 25.0 86.7
19 7.4 7.7 94.4
14 5.4 5.6 100.0
248 96.5 100.0
9 3.5
257 100.0
1
2
3
4
5
6
7
Total
Valid
System Missin
Total
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
'kra! din(in
2 .8 .8 .8
255 99.2 99.2 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
)yeri e%i(astriu$
79 30.7 30.7 30.7
178 69.3 69.3 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
Sakit ke%a!a
156 60.7 60.7 60.7
101 39.3 39.3 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent




*ia!(ia
36 14.0 14.0 14.0
221 86.0 86.0 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
'tra!(ia
20 7.8 7.8 7.8
237 92.2 92.2 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
*ua!
174 67.7 67.7 67.7
83 32.3 32.3 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
*unta+
114 44.4 44.4 44.4
143 55.6 55.6 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
,iare
19 7.4 7.4 7.4
238 92.6 92.6 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent




He%ato$e(a!i
14 5.4 5.4 5.4
243 94.6 94.6 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
S%!eno$e(a!i
2 .8 .8 .8
255 99.2 99.2 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
-a$%e!eed
110 42.8 42.8 42.8
147 57.2 57.2 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
.etekie
100 38.9 38.9 38.9
157 61.1 61.1 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
/ki$osis
4 1.6 1.6 1.6
253 98.4 98.4 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent




/%istaksis
24 9.3 9.3 9.3
233 90.7 90.7 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
.erdara+an (usi
9 3.5 3.5 3.5
248 96.5 96.5 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
He$ate$esis
4 1.6 1.6 1.6
253 98.4 98.4 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
He$o%tisis
1 .4 .4 .4
256 99.6 99.6 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
*e!ena
9 3.5 3.5 3.5
248 96.5 96.5 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent




He$aturia
3 1.2 1.2 1.2
254 98.8 98.8 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
Tran0usi
35 13.6 13.6 13.6
222 86.4 86.4 100.0
257 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent




Syok
Frequency Ta!e
"sia
10 71.4 71.4 71.4
2 14.3 14.3 85.7
1 7.1 7.1 92.9
1 7.1 7.1 100.0
14 100.0 100.0
< 21 th
21 - 30 th
31 - 40 th
51 - 60 th
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
#ender
6 42.9 42.9 42.9
8 57.1 57.1 100.0
14 100.0 100.0
)a*i-la*i
&e"em+$an
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
*asuk u!an
3 21.4 21.4 21.4
3 21.4 21.4 42.9
4 28.6 28.6 71.4
1 7.1 7.1 78.6
1 7.1 7.1 85.7
1 7.1 7.1 92.9
1 7.1 7.1 100.0
14 100.0 100.0
1
2
3
4
6
7
11
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
La$a ina%
1 7.1 7.1 7.1
6 42.9 42.9 50.0
1 7.1 7.1 57.1
3 21.4 21.4 78.6
2 14.3 14.3 92.9
1 7.1 7.1 100.0
14 100.0 100.0
1
3
4
5
6
7
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent




La$a de$a$ see!u$ dira&at
1 7.1 7.1 7.1
6 42.9 42.9 50.0
1 7.1 7.1 57.1
4 28.6 28.6 85.7
1 7.1 7.1 92.9
1 7.1 7.1 100.0
14 100.0 100.0
2
3
4
5
6
7
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
Statistics
14 14
0 0
4.07 4.07
3.50 3.50
3 3
1.639 1.439
2.687 2.071
1 2
7 7
Valid
Missin
-
Mean
Median
Mode
Std. .e(iation
Va"ian%e
Minim$m
Ma/im$m
)ama ina+
)ama demam
se0el$m
di"a1at
'kra! din(in
4 28.6 28.6 28.6
10 71.4 71.4 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
)yeri e%i(astriu$
5 35.7 35.7 35.7
9 64.3 64.3 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
Sakit ke%a!a
8 57.1 57.1 57.1
6 42.9 42.9 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
*ia!(ia
2 14.3 14.3 14.3
12 85.7 85.7 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent




'tra!(ia
3 21.4 21.4 21.4
11 78.6 78.6 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
*ua!
10 71.4 71.4 71.4
4 28.6 28.6 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
*unta+
7 50.0 50.0 50.0
7 50.0 50.0 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
,iare
3 21.4 21.4 21.4
11 78.6 78.6 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
He%ato$e(a!i
14 100.0 100.0 100.0 Tida* Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
S%!eno$e(a!i
14 100.0 100.0 100.0 Tida* Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
-a$%e!eed
3 21.4 21.4 21.4
11 78.6 78.6 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent




.etekie
7 50.0 50.0 50.0
7 50.0 50.0 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
/ki$osis
14 100.0 100.0 100.0 Tida* Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
/%istaksis
1 7.1 7.1 7.1
13 92.9 92.9 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
He$ate$esis
1 7.1 7.1 7.1
13 92.9 92.9 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
He$o%tisis
14 100.0 100.0 100.0 Tida* Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
*e!ena
1 7.1 7.1 7.1
13 92.9 92.9 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
He$aturia
14 100.0 100.0 100.0 Tida* Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
Tran0usi
4 28.6 28.6 28.6
10 71.4 71.4 100.0
14 100.0 100.0
,a
Tida*
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent




+ari syok
5 35.7 35.7 35.7
7 50.0 50.0 85.7
2 14.3 14.3 100.0
14 100.0 100.0
3.00
5.00
6.00
Total
Valid
!"e#$en%y &e"%ent Valid &e"%ent
'$m$lati(e
&e"%ent
Statistics
ha"i syo*
14
0
4.4286
5.0000
5.00
1.15787
1.341
Valid
Missin
-
Mean
Median
Mode
Std. .e(iation
Va"ian%e
Ga0%a1 3. G1a-( leta( Cut Off Point "la 1ata61ata 4'0lah le'(!#t




85<5,+ 80=<,5 8<=0
S'(k >3@ S'(k >P@
1rosstas
1ase .rocessin( Su$$ary
271 100.02 0 .02 271 100.02 le$*osit "ata-"ata 3 Syo*
- &e"%ent - &e"%ent - &e"%ent
Valid Missin Total
'ases
!eukosit rata2rata 3 Syok 1rosstau!ation
6 131 137
7.1 129.9 137.0
8 126 134
6.9 127.1 134.0
14 257 271
14.0 257.0 271.0
'o$nt
4/+e%ted 'o$nt
'o$nt
4/+e%ted 'o$nt
'o$nt
4/+e%ted 'o$nt
<5673
>55673
le$*osit "ata-"ata
Total
,a Tida*
Syo*
Total
1+i2Square Tests
.350
0
1 .554
.100 1 .751
.351 1 .554
.594 .376
.349 1 .555
271
&ea"son 'hi-S#$a"e
'ontin$ity 'o""e%tion
a
)i*elihood 6atio
!ishe"7s 4/a%t Test
)inea"-0y-)inea"
8sso%iation
- o9 Valid 'ases
Val$e d9
8sym+. Si.
:2-sided;
4/a%t Si.
:2-sided;
4/a%t Si.
:1-sided;
'om+$ted only 9o" a 2/2 ta0le
a.
0 %ells :.02; ha(e e/+e%ted %o$nt less than 5. The minim$m e/+e%ted %o$nt is 6.
92.
0.
-isk /sti$ate
.721 .243 2.138
.734 .262 2.058
1.017 .962 1.075
271
<dds 6atio 9o" le$*osit
"ata-"ata :<5673 =
>55673;
!o" %oho"t Syo* 5 ,a
!o" %oho"t Syo* 5 Tida*
- o9 Valid 'ases
Val$e )o1e" >++e"
952 'on9iden%e
?nte"(al




/4.L5-/
S657
1ase .rocessin( Su$$ary
14 100.02 0 .02 14 100.02
257 100.02 0 .02 257 100.02
Syo*
,a
Tida*
le*o"ata@T
- &e"%ent - &e"%ent - &e"%ent
Valid Missin Total
'ases
,escri%ti8es
5969.1310 850.77398
4131.1455
7807.1164
5722.1825
5165.4167
14A007
3183.305
2000.00
14383.33
12383.33
3915.00
1.552 .597
2.860 1.154
5376.9945 143.20114
5094.9922
5658.9968
5200.3650
4918.7500
5270188
2295.689
1660.00
15600.00
13940.00
2467.08
1.304 .152
2.339 .303
Mean
)o1e" Bo$nd
>++e" Bo$nd
952 'on9iden%e
?nte"(al 9o" Mean
52 T"immed Mean
Median
Va"ian%e
Std. .e(iation
Minim$m
Ma/im$m
6ane
?nte"#$a"tile 6ane
S*e1ness
C$"tosis
Mean
)o1e" Bo$nd
>++e" Bo$nd
952 'on9iden%e
?nte"(al 9o" Mean
52 T"immed Mean
Median
Va"ian%e
Std. .e(iation
Minim$m
Ma/im$m
6ane
?nte"#$a"tile 6ane
S*e1ness
C$"tosis
Syo*
,a
Tida*
le*o"ata@T
Statisti% Std. 4""o"




).ar Tests
*ann29+itney Test
-anks
14 146.89 2056.50
257 135.41 34799.50
271
Syo*
,a
Tida*
Total
le*o"ata@T
- Mean 6an* S$m o9 6an*s
Test Statistics
a
1646.500
34799.500
-.534
.593
Mann-Dhitney >
Dil%o/on D
E
8sym+. Si. :2-tailed;
le*o"ata@T
F"o$+in Va"ia0leG Syo*
a.