Electronic Theses and Dissertation

Latar belakang: Talasemia mayor dengan gejala klinis anemia berat berisiko
mengalami gangguan pertumbuhan dan perkembangan, salah satunya pubertas
terlambat. Pubertas terlambat pada penderita talasemia disebabkan oleh anemia
kronis dan kelebihan zat besi. Pada talasemia β mayor, sebagian penderita
mengalami ketidakseimbangan tulang tubuh. Pemeriksaan kadar hemoglobin pratransfusi dan feritin bertujuan untuk menentukan anemia kronis dan kelebihan zat
besi sementara bone age untuk menilai usia tulang pada talasemia β mayor.
Tujuan: mengetahui hubungan antara kadar hemoglobin pra-transfusi, feritin dan
bone age terhadap pubertas terlambat pada anak dengan talasemia β mayor.
Metode: Penelitian menggunakan desain penelitian observasional analitik cross
sectional. Terdapat 50 siswa memenuhi kriteria penelitian. Data penelitian diperoleh
dari Tanner Stage, pemeriksaan kadar hemoglobin pra-transfusi, feritin, dan bone
age. Analisis bivariat menggunakan uji tes t independen dan chi square.
Hasil: Sampel penelitian terbanyak perempuan sejumlah 20 sampel (40,0%) pada
kelompok pubertas terlambat sementara pada kelompok pubertas tidak terlambat
terbanyak laki-laki sejumlah 15 sampel (30,0%). Nilai median rerata kadar
hemoglobin pra-transfusi yaitu 7,51 gr/dl dan feritin yaitu 6.055 ng/ml pada
kelompok pubertas terlambat sementara pada kelompok pubertas tidak terlambat
nilai median rerata hemoglobin pra-transfusi yaitu 7,96 gr/dl dan feritin yaitu
3.382,12 ng/ml. Bone age terlambat lebih sering ditemukan pada kelompok pubertas
terlambat sebanyak 17 sampel (34,0%). Analisis bivariat memperlihatkan variabel
bone age sebagai variabel yang memiliki hubungan dengan pubertas terlambat (p
0,001, OR 2,60)
Kesimpulan: Kadar hemoglobin pra-transfusi dan feritin tidak memiliki hubungan
dengan pubertas terlambat sementara bone age memiliki hubungan dengan pubertas
terlambat pada anak dengan talasemia β mayor.
Kata kunci: bone age, feritin, hemoglobin pra-transfusi, pubertas terlambat, talasemia
β mayor

Background: Thalassemia major with clinical manifestation of severe anemia are at risk for growth and developmental disorders, one of which is delayed puberty. Delayed puberty in thalassemia’s patients are caused by chronic anemia and excess iron. In β thalassemia major, some patients have experienced an imbalance of bone shape. Pre-transfusion hemoglobin and ferritin levels examination aim to determine the chronic anemia and iron excess whether bone age evaluates the age of bone in β thalassemia major. Objective: To determine the relationship between pre-transfusion hemoglobin, ferritin levels and bone age with delayed puberty in β thalassemia major’s children. Methods: The study used a cross-sectional analytical observational research design. Fifty students met the study criteria. Data were obtained from the Tanner Stage, pretransfusion hemoglobin, ferritin level, and bone age examinations. Bivariate analysis used independent t-tests and chi-square tests. Results: The majority of the study samples were female, with 20 samples (40.0%) in the delayed puberty group, while the majority of the non-delayed puberty group were male, with 15 samples (30.0%). The median of average pre-transfusion hemoglobin level was 7.51 g/dl and ferritin level was 6,055 ng/ml in the delayed puberty group, while in the non-delayed puberty group, the median of average pre-transfusion hemoglobin level was 7.96 g/dl and ferritin level was 3,382.12 ng/ml. Delayed bone age was more frequently found in the delayed puberty group, with 17 samples (34.0%). Bivariate analysis showed that bone age was a variable associated with late puberty (p 0.001, OR 2.60). Conclusion: Pre-transfusion hemoglobin and feritin level do not have relationship with delayed puberty whether bone age has relationship with delayed puberty in children with β thalassemia major.