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LABORATORIUM
FAAL HATI
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ANATOMI HEPAR
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This organ plays a major role in metabolism and has a number of
functions in the body :
glycogen storage,
decomposition of red blood cells,
plasma protein synthesis,
hormone production, and
detoxification.
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SYNTHESIS FUNCTION
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Cont….
produces and excretes bile (a greenish liquid) required for emulsifying fats.
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BREAKDOWN FUNCTION
The liver breaks down hemoglobin, creating metabolites that are added
to bile as pigment (bilirubin and biliverdin).
The liver breaks down or modifies toxic substances (eg. methylation) and
most medicinal products in a process called drug metabolism. This
sometimes results in toxication, when the metabolite is more toxic than
its precursor. Preferably, the toxins are conjugated to avail excretion in
bile or urine.
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OTHER FUNCTIONS
The liver produces albumin, the major osmolar component of blood serum.
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LIVER FUNCTION TESTS (LFTs or LFs)
which include liver enzymes, are groups of clinical biochemistry
laboratory blood assays designed to give information about the state
of a patient's liver.
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Several biochemical tests are useful in the evaluation and
management of patients with hepatic dysfunction.
These tests can be used to :
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Pemeriksaan Laboratorium
untuk penyakit hati, bertujuan :
1. Skrining
2. Diagnosis
3. Monitoring
4. Prognosis
Faal Hati :
1. Fungsi ekskresi : bilirubin, bile acids
2. Fungsi sintesa : protein, albumin, Fx Koagulasi
Cholinesterase (CHE)
3. Fungsi metabolik
Kerusakan Hati : ensim-ensim hati (SGOT, SGPT)
Obstruksi Hati : bilirubin, ALP, GGT
Keganasan Hati : AFT
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ENSIM – ENSIM HATI
Penyakit hati
kadar serum ensim sel hati:
- sitosolik
- mitokondrial
- membran >>>
SGOT / AST (aspartate aminotransferase)
SGPT / ALT ( alanine aminotransferase)
ALP (akaline phosphatase)
GGT (γ-glutamyltransferase)
CHE ( cholinesterase)
G-LDH (LDH) (Lactic-dehydrogenase)
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AMINOTRANSFERASE
AST / SGOT
ensim mitokondrial & sitoplasmik
distribusi : jantung, hati, otot skeletal, ginjal
ALT / SGPT
ensim membran hepatosit & sitoplasmik
distribusi : hati, ginjal
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JAUNDIS / IKTERIK
Penyebab :
Penyakit Hati
bukan penyakit hati :
- Hemolisis
- gangguan metabolisme bilirubin
Bilirubin yg diperiksa :
bilirubin total
bilirubin direk : conjugated bilirubin & δ bilirubin
bilirubin indirek (unconjugated) = total - direk
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KLASIFIKASI HIPERBILIRUBINEMIA INDIREK
/UNCONJUGATED
Produksi dari heme >>> : Penurunan pengangkutan ke hati :
- hemolisis - congestive heart failure
- eritropoisis inefektif - portacaval shunt
Penurunan drainase :
- Obstruksi ekstrahepatik:
batu striktur
carcinoma atresia
- Sclerosing cholangitis
- Obstruksi intrahepatik :
obat primary biliary cirrhosis
granuloma bile duct paucity
tumor
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ALBUMIN
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TES FUNGSI HATI
TES FUNGSI
Bilirubin Diagnosa jaundis, berkorelasi dg keparahan
ALP Diagnosa kolestasis & space occupying lesions
Fraksi bilirubin Diagnosa gangguan metabolisme & jaundice of the new
born
AST (SGOT) Tes yg sensitif untuk penyakit hepatoseluler,
SGOT > SGPT pada penyakit alkohol & penyakit hati kronik
berat
ALT (SGPT) Tes yg sensitif & lebih spesifik untuk penyakit
hepatoseluler
Albumin Indikator kronisitas & keparahan
Prothrombin time Indikator keparahan & kolestasis
(PT)
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