biokimia sistem hematologi regular

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    MEMBRAN BIOLOGI

    ASPEK-ASPEK BIOKIMIA DARAH

    HEMOGLOBIN

    dr. Jangki Hashumal S.Bi!k

    BAGIAN BIOKIMIA

    "AK#L$AS KEDOK$ERAN #NHAS

    BIOKIMIA

    SISTEM HEMATOLOGI

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    ASPEK-ASPEK BIOKIMIADARAH

    $u%uan P&m'&la%aran

    P&ndahuluan

    As&k Bi!kimia Plasma Darah

    As&k Bi!kimia Eri(r!si(

    As&k Bi!kimia L&uk!si(As&k Bi!kimia $r!m'!si(

    K&simulan

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    $u%uan P&m'&la%aranS&(&lah m&m&la%ari kuliah inimahasis)a daa(*

    M&n%&laskan as&k 'i!kimia

    lasma darahM&n%&laskan as&k 'i!kimia

    &ri(r!si(M&n%&laskan as&k 'i!kimial&uk!si(

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    M&n%&laskan as&k'i!kimia (r!m'!si(

    M&%&laskan as&k-as&k'i!kimia hu'ungann+a

    d&ngan &n+aki( a(auk&adaan a(!l!gis

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    P&ndahuluan

    Darah mruakan sua(u ,airan +mngandung 'r'agai m!l&kul +g

    '&rariasi k!m!n&n s&lul&r

    K!m!n&n s&lul&r (&rdiri a(as*

    Eri(r!si(

    L&uk!si( /granul!si(0 m!n!si(0lim1!si(2

    $r!m'!si(

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    P&rs&n(asi !lum& 'agianunsur3 s&lul&r0/h&ma(!kri(20adalah 4567dr k&s&luruhan !lum&darah

    M&miliki '&ra( 487 dari'&ra( (u'uh manusia

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    Fungsi darah

    $rans!r /!ksig&n0 kar'!ndi!ksida0nu(ri&n(0

    h!rm!n0m&(a'!li(2H!m&!s(asis /a,id-'as& 'alan,&0

    )a(&r 'alan,&0suhu (u'uh2P&r(ahanan (u'uh

    Self-protection /k!agulasi2

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    As&k Bi!kimia PlasmaDarah

    Plasma adl sua(u laru(an &n,&r +g(rdiri a9 &l&k(r!li(0:a(3 makanan0m&(a'!li(0r!(&in0trace element0

    signaling substance

    K!m!sisi air &l&k(r!li( lasma 4 ;k!m!sisi sluruh ,airan &ks(ras&lul&r

    P&n&n(uan kadar Na

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    Protein plasma

    Mrkan km!n&n (r'&sar dr lasmadarah dng k!ns&n(rasi C-8Cg9l.

    57 dr slruh r!(&in (u'uh adl

    r!(&in lasma

    $rd( 4CC m,m r!(&in lasma +g

    'r'adaBrdsrkan misahan dgn m(!d&&l&k(r!1!r&sis r!(&in d( di'gi mn%d

    6 klm!k /g'r2

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    B ' i1 i d

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    B&'&raa si1a( &n(ing dansin(&sis r!(&in lasma

    S'agian 'sar r!(&inlasma disin(&sis didlm s&l3 ha(i /k&,. Ig r!(&!h!rm!n2

    Hamir sluruh r!(&inlasma mruakanglik!r!(&in

    B'raa r!(&in lasmamnun%ukkan!lim!r1ism&

    A,u(& has& r!(&in

    and =-r&a,(i& r!(&in

    Sin(&sis r!(&inlasma

    H&a(!si(

    Sm!!(h&nd!lasmi, m&m'ran&

    M&m'ran&-'!und

    !l+ri'!s!m&s

    R!ugh&nd!lasmi,m&m'ran&

    G!lgiaara(us

    S&,r&(!r+&si,l&s

    Plasma

    A h i d =

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    A,u(& has& r!(&in and =-r&a,(i& r!(&in

    Pd r&s!n 1as& aku(

    (rd( ru'ahan !la

    dr r!(&in (((0sr(iningka(an sin(&sis

    ''raa r!(&in (ru(ama +gdisin(&sis diha(i nurunank!ns&n(rasi r!(&in lasma +g

    lainn+a

    A,u(& has&r&s!ns&

    m&ruakanr&s!n

    n!ns&si1ik adal&si %aringan a(au

    in1&ksi

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    -an(i(r+sin0 r!(&in-r!(&ink!agulasi /1i'rin!g&n0r!(r!m'in0 r!(&in-r!(&in

    k!ml&m&n dan CRP2 m&ningka(ada r&s!n 1as& aku(

    Sin(&sis al'umin0 (rans(h+r&(in/r&al'umin2 dan (rans1&rinm&nurun ada r&s!ns 1as& aku(

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    CRPMruakan k!m!n&n u(ama dr

    r&s!n 1as& aku( &(anda adan+ain1&ksi 'ak(&riDisin(&sis diha(i s'agai r!(&in dngn

    lima su'uni( m&miliki '&ra(m!l&kul s&'&sar ?C kDaK!ns&n(rasi n!rmal F mg9L

    Br1ungsi m&m&diasi ika(an dngn!lisakarida asing01!s1!liid !liani!n k!ml&ks sr(a mngak(iasi

    k!ml&m&n m&lalui %alur klasik

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    As&k Bi!kimia Eri(r!si(Eri(r!si( mruakan r!duk akhir dr

    &ri(r!!&sis +g 'rlngsng didlm smsum(ulang di')h k!n(r!l &ri(r!!&(in+gdir!duksi !9 gin%al

    Eri(r!si( 'kn mruakan s&l +gssungguhn+a krn (dk mmiliki in(i !rgan&l in(ras&lul&r

    Eri(r!!&(in mruakan glik!r!(&in dgn aa '&r'&ra(m!l&kul ?5 kDa mruakan r&gula(!r u(ama &ri(r!!&sis+g dil&askan k& aliran darah s&'agai r&s!ns (rhadahi!ksia. R&s&(!r s&si1ik &ri(r!!&(in (rd( d

    m&m'ran s&l3 r!g&ni(!r &ri(r!si( dlm sumsum (ulang'rua r!(&in (ransm&m'ran.

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    "ungsi u(ama &ri(r!si(adalah m&ngangku( !ksig&n

    k& %aringan dan m&m'an(u&ng&luaran kar'!ndi!ksidadan H

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    Hematopoesis

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    M&(a'!lism& ana&r!' di dalams&l darah m&rah

    Sa(u &r'&daan &n(ing an(ara&ri(r!si( d&ngan r&kurs!rn+a

    /&ri(r!'las dan r&(ikul!si(2adalah hilangn+a mi(!k!ndria

    Mi(!k!ndria hilang >5 %ams&(&lah r&(ikul!si( m&masukisirkulasi

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    S&'agai k!ns&ku&nsin+a0

    sin(&sis A$P (&r%adi m&lalui%alur ana&r!'ik /glik!lisis2

    P&m'&n(ukan NADPH han+am&lalui %alur &n(!sa 1!s1a(

    Gluk!sa m&ruakan 'ahan'akar u(ama 'agi s&l darahm&rah +ang ma(ur&

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    Metabolisme Eritrosit

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    As&k-as&k &n(ing

    m&(a'!lism& s&l darah m&rahEri(r!si( m&miliki k&(&rga(ungan+ang (inggi ada gluk!sa s&'agai

    sum'&r &n&rgin+a. M&m'ran&ri(r!si( m&miliki (rans!r(&r +ang'&ra1ini(as +ang (inggi (&rhada

    gluk!saGlik!sis m&nghasilkan lak(a( s'agai

    r!duk saming dari A$P

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    Kar&na (idak m&miliki

    mi(!k!ndria0 &ri(r!si( (idakm&mr!duksi A$P m&lakui1!s1!rilasi !ksida(i1Pr!duksi >0?-'i1!s1!glis&ra(0!l&h r&aksi +ang (&rkai(

    glik!lisis0 &n(ing dalamm&r&gulasi k&mamuan H'dalam m&n(ras!r( !ksig&n

    Sin(&sis > ? 'i1!s1!glis&ra( dlm

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    Sin(&sis >0?-'i1!s1!glis&ra( dlm&ri(r!si(

    A k3 i ' liA k3 (i ( ' li

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    Jalur &n(!sa 1!s1a( /%al. h&ks!sam!n!1!s1a(;HMP2'rran didlm&ri(r!si( mmrduksi NADPH

    Glu(a(i!n (r&duksi /GSH2 n(ing dm&(. &ri(r!si(0khsusn+a dlm mnga(asi

    !(&nsi (!ksik dr &r!ksida.Eri(r!si(d( mnsin(&sis GSH mm'u(uhknNADPH u9 mngm'alikan glu(a(i!n

    (&r!ksidasi d k&adaan (r&duksi.

    As&k3 &n(ing m&(a'!lism&As&k3 &n(ing m&(a'!lism&

    s&l darah m&rahs&l darah m&rah

    R k i (i l i dl i( i(R k i (i l i dl i( i(

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    R&aksi n(ing +g lain dlm &ri(r!si(R&aksi n(ing +g lain dlm &ri(r!si(

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    B&si didlm H' hrs dir(hankan dk&adaan "&>

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    Eri(r!si( m&ngandung &n:im(&r(&n(u dari m&(a'!lism&

    nukl&!(ida /,!n(!h* ad&n!sind&aminas&0 irimidin&nukl&!(idas&0 dan ad&nilil

    siklas&2. D&1isi&nsi dari &n:im-&n:im ini (&rli'a( dalam kasusan&mia h&m!li(ik

    As&k n(ing m&(As&k n(ing m&(..s&ls&l

    darah m&rahdarah m&rah

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    Su&r!ksida dismu(as&0 ka(alas&Su&r!ksida dismu(as&0 ka(alas&

    glu(a(i!n m&lindungi s&l3 darahglu(a(i!n m&lindungi s&l3 darahdr s(dr s(rr&ss !ksida(i1&ss !ksida(i1 k&rusakank&rusakan

    B'raa !ksidan kua( dirduksislma r!s&s m&(.

    ai(u su&r!ksida /O>-20

    hidr!g&n &r!ksida/H>O>20radikal &r!ksil /ROO.2 danradikal hidr!ksil /OH.2

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    Oksidan3 (rs&'u( dis'u( s'gaireactive oxygen species/ROS2Radikal '&'as mruakan a(!m a9

    klm!k a(!m +g mmiliki &l&k(r!n

    +g (dk 'rasanganOH.mruakan m!l&kul r&ak(i1+g d( '&r&aksi mm&ngaruhi

    s(ruk(ur r!(&in0asamnukl&a(0liid m!l&kul lain +gm&n+&'a'kan k&rusakan

    %aringan.

    R k i3 (i ' h 'R k i3 (i ' h '

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    R&aksi3 &n(ing +g '&rhu'unganR&aksi3 &n(ing +g '&rhu'ungan

    d&ngan s(r&sd&ngan s(r&sss!ksida(i1!ksida(i1

    . Pr!duksi su&r!ksida /r!duk samingdari '&r'agai r&aksi2

    >. NADPH-!ksidas&

    O> < & O>.

    $&r'&n(uk di dalam &ri(r!si( !l&h au(!!ksidasi dari4?7H' m&n%adi m&(H' ada s&l lain (&r'&n(uk !l&hk&r%a &n:im si(!kr!m P56! r&duk(as& dan an(in!ksidas&

    >O> < NADPH >O>. < NADP < HO> mn%adiH>O dan O> r&aksi ini mruakan slh sa(u r&aksi +g

    mlindungi s&l dr s(r&s !ksida(i1 krusakan aki'a( H>O>

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    . Glu(a(i!n &r!ksidas&> GSH < R-O-OH GSSG < H>O < ROH

    . R&aksi "&n(!n"&>O> "&?

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    Pr!!ksidan0an(i!ksidan0Pr!!ksidan0an(i!ksidan0

    s(r&s !ksida(i1s(r&s !ksida(i1

    Pr!!ksidanmrakan km!n&nkimia r&aksi3 +g mmliki kmmuanu9 mm'n(uk s&si&s !ksig&n (!ksik

    An(i!ksidanmrakan km!n&nkimia r&aksi3 +g mmu mn&(ralisir mn&kan m'n(ukan s&si&s!ksig&n (!ksik. g (rmasukan(i!kasidan an(ara lain

    NADPH0GSH0asam ask!r'a( i( E

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    Didlm s&l n!rmal (r%dks&im'angan a9 r!!ksidan

    an(i!ksidan.

    Aa 'l (r%d rgs&ran

    k&s&im'angan0r!!ksi mningka( a9 an(i!ksidan +g

    'rkurang mk (r%d k&adaan +g

    dis'( s(r&s !ksida(i1s(r&s !ksida(i10+g %k'rlngsung lama masi1 d(

    mn+'a'kan krusakan s&l +g srius.

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    Dfisiensi glukosaDfisiensi glukosa66fosfat dhidrogenasefosfat dhidrogenaseMu(asi ada g&n& &ngk!d& GPD

    P&nurunan ak(i1i(as GPD

    P&nurunan k!ns&n(rasi NADPH

    Pnrunan rg&n&rasi GSH dr GSSG !9 glura(i!n r&duk(as&

    Oksidasi gugus SH dr H' r!(&in mm'ran aki'a(nrunan l&&l GSH ningka(an !ksidan in(ras&lular

    mmngaruhi s(ruk(ur mm'ran mningka(kansus&(i'ili(as (&ring&s(i !9 makr!1ag

    H&m!lisis

    A k i '

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    As&k &n(ing m&m'ran&ri(r!si(

    Mm'ran &ri(r!si( (rsusun 'ila+&rdgn 6C7 liid 6C7 r!(&in

    Liid u(aman+a adl kls 1!s1!liid k!l&s(&r!l

    Analisa dgn SDS-PAGE mnn%ukkan

    mm'ran mngandung C r!(&inma+!r l'h dr CC r!(&in min!r

    i ' i i

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    Pr!(&in ma+!r mm'ran &ri(r!si(an(ara lain s&k(rin0 ankirin0

    ani!n &,hang& r!(&in0ak(in 'and 5.

    S&k(rin0ankirin r!(&in&ri1&r d mm'ran &ri(r!si('rran dlm 'n(uk

    1lksi'ili(asn+aS'gian '&sar r!(&in mm'ran

    &ri(r!si( mruakan glik!r!(&in

    A'n!rmali(as s&k(rin mn+''knA'n!rmali(as s&k(rin mn+''kn

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    A'n!rmali(as s&k(rin mn+''knA'n!rmali(as s&k(rin mn+''kn

    s1&r!si(!siss1&r!si(!sis

    Mu(asi DNA mm&ngaruhi %mlh a9 s(ruk(ur drs&k(rin r!(&in si(!sk&l&(al sr(i ankirin0'and

    ? 'and 5.

    Ml&mahkan in(&raksi an(ara r!(&in &ri1&r in(&gral d mm'ran &ri(r!si(

    M&l&mahkan s(ruk(ur m&m'ran &ri(r!si(

    Eri(r!si( 'r'n(uk s1&ris mudah (rd&s(ruksi !9lima

    An&mia h&m!li(ik

    B'r n+ki( aki'( klainan d &ri(r!si(B'r n+ki( aki'( klainan d &ri(r!si(

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    B'r n+ki( aki'( klainan d &ri(r!si(B'r n+ki( aki'( klainan d &ri(r!si(P&n+aki( P&n+&'a' #(ama

    An&mia d&1isi&nsi '&si In(ak& +ang inad&kua( a(au k&hilangan '&si +ang &ks&si1

    M&(h&m!gl!'in&miaIn(ak& !ksidan +g 'rl'ihan /!'a( a9 'ahan kimia lainn+a2D&1isi&nsi g&n&(ik ada sis(&m m&(h&m!gl!'in r&duk(as& +g 'rgan(ung NADH

    Si,kl& =&ll An&miaGAG G$G /alin as.glu(ama(2 d k!d!n ran(ai H'

    -(halass&mia Mu(asi ada g&n -gl!'in

    -(halass&mia Mu(asi ada g&n -gl!'in

    An&mia m&gal!'las(ikD&1isi&nsi i(. B>D&1isi&nsi as. 1!la(

    P&nurunan a's!rsi B> / d&1isi&nsi 1ak(!r in(rinsik2Kurangn+a in(ak&0 d&1&k a's!rsi0nngka(an k&'u(uhanas. "!la(

    S1&r!si(!sis h&r&di(&rKlainan s(rk(ur r!(&in s&k(rin0ankirin0'and ? 'and5.

    D&1isi&nsi GPD B&r'agai ariasi mu(asi ada g&n &ngk!d& GPD

    D1isi&nsi irua(kinas&

    Mu(asi ada g&n &ngk!d& is!&n:im PK

    H&m!gl!'in&mian!k(urnal ar!ksismal Mu(asi d g&n PIG-A0 +g mm&ngaruhi sin(&sis GPI-an,h!r&d r!(&in

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    DsDsaar Bi!kimia G!lr Bi!kimia G!l..DarahDarah

    G!l. darah mru%uk d sis(&m (r(n(u dran(ig&n +g (rd( d mm'ran &ri(r!si(

    Sis(&m ABO

    Sis(&m Rh&sus /Rh2Sis(&m MN

    Is(ilah g!l. darah 'rdsrkan d 1&n!(i&

    an(ig&nik +g 'iasan+a diknali dngn ,rmnggnakan an(i'!di +g s&suai

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    L&ngan an%ang dr kr!m!s!m +g

    'r(nggng %)' dlm rduksi su's(ansiABO (rd( ? al&l +g mm'n(k 51&n!(i& A0B0AB0 O0+ai(u al&l

    k!d!minan A B al&l r&s&si1 OPada sis(&m ABOG!l. darah A* mmiliki an(ig&n A d mm'ran

    &ri(r!si( an(i'!di an(i-B d lasman+a.G!l. darah B* mmiliki an(ig&n B d mm'ran

    &ri(r!si( an(i'!di an(i-A d lasman+a.

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    G!l. darah AB* (idak m&miliki an(i'!di an(i-Adan an(i-B ada lasman+a

    G!l. darah O* (idak m&miliki an(ig&n Amauun B ada m&m'ran &ri(r!si(

    G!l. darah AB m&ruakan r&s&i&nuni&rsal

    G!l. darah O m&ruakan d!n!runi&rsal

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    As&k Bi!kimia L&uk!si(

    L&uk!si( mrakan k&l!m!k s&l+g 'rran dlm m&kanism&r(ahanan (u'uh

    $&rdiri a(as*Granul!si( /n&u(r!1il0 &!sin!1il0 dan

    'as!1il2Lim1!si( /lim1!si( B dan lim1!si( $2

    M!n!si(

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    J&nis-%&nis l&uk!si( di(&n(ukan!l&h '&n(uk0 1ungsi0 dan (&ma(&m'&n(ukann+a

    S&'agian '&sar l&uk!si(dir!duksi di sumsum (ulang0

    s&'agian k&,il di dalam (imus

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    N&u(r!1il

    M&ruakan l&uk!si( d&ngan&rs&n(as& aling '&sar +ai(u 67dari s&luruh l&uk!si(

    M&ruakan s&l 1ag!si( +ang

    m!(il0 m&miliki &ran u(ama adr!s&s in1lamasi aku(

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    As&k 'i!kimiaAs&k 'i!kimia

    u(ama n&u(r!1ilu(ama n&u(r!1ilGlik!lisis ak(i1Jalur &n(!sa 1!s1a( ak(i1

    "!s1!rila(i1 !ksida(i1 +ang m!d&ra(Ka+a akan lis!s!m &n:im d&grada(i1Mngndung r!(&in &n:im (r((u +g unik

    /mi&l!&r!ksidas& NADPH-!ksidas&2Mngndung in(&grin =D9=D8 d

    mm'ran s&ln+a

    B'r &n:imB'r &n:im r!(&in &n(ing n&u(r!1ilr!(&in &n(ing n&u(r!1il

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    B'r &n:imB'r &n:im r!(&in &n(ing n&u(r!1ilr!(&in &n(ing n&u(r!1il

    En:im a(au Pr!(&in R&aksi +ang Dika(alisis P&n%&lasan

    Mi&l!&r!ksidas&

    /MPO2

    H>O> < Q-/halida2 < HO /=!n(!h* Q ; =l HOQ;as.hi!kl!rida2

    B&r(anggung%a)a' (&rhada )arnahi%au ada us

    D&1isi&nsi g&n&(ik daa(m&n+&'a'kan in1&ksi '&rulang

    NADPH-!ksidas& >O> < NADPH >O>.< NADP < H.0 H>O>0 OH.0 O=l-/i!n hi!kl!ri(&2

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    B&'&raa r!duk ini daa('&r1ungsi s&'agai ag&nmikr!'isidal +ang !(&n

    Sis(&m ran(ai (rans!r( &l&k(r!n+ang '&r(anggung%a)a' ada

    r&sira(!r+ 'urs( dis&'u( NADPH!ksidas&

    R i ( ' (R i ( ' (

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    R&sira(!r+ 'urs(R&sira(!r+ 'urs(

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    Dr rs&s (rs'u( dia(as hidr!g&n

    &r!ksida (r'n(uk s,ra s!n(anm&lalui r&aksi*

    O> < O> < >H H>O> < O>H>O> sln%u(n+a dirlukan u9

    ak(i1i(as &n:im mi&l!&r!ksidas&

    a9 din&(ralisir mlalui 1ungsiglu(a(i!n &r!ksidas& ka(alas&

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    Pr!s&s &m'unuhan 'ak(&ri di

    dalam 1ag!lis!s!m '&rgan(ungada k!m'inasi dari

    &ningka(an H0 i!nsu&r!ksida0 dan d&ria( !ksig&ns&r(a &(ida 'ak(&risidal

    /d&1&nsin20 ,a(h&sin G0 r!(&inka(i!nik.

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    Mi&l!&r!ksidas&Mi&l!&r!ksidas&

    N&u(r!1il m&miliki &n:im +ang unik+ang dis&'u( mi&l!&r!ksidas&

    En:im ini m&ngka(alisis r&aksi*

    H>O>

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    =l- kar&na m&miliki %umlah +ang

    '&sar di dalam s&l0 m&m'&n(uk HO=l/asam hi!kl!ra(2HO=l '&rsi1a( m&rusak s&l s&kaligus

    mikr!'isidal +ang kua(Di dalam s&l HO=l '&raksi d&ngan

    amin& m&m'&n(uk kl!ramin +ang

    (idak m&n+&'a'kan k&rusakan%aringan namun (&(a '&r!(&nsis&'agai mikr!'isidal

    As&k Bi!kimia H&m!s(asis

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    As&k Bi!kimia H&m!s(asisH&m!s(asis mrakan m&kanism& +g

    'r1ungsi mmrk&,il khilangan darahm&lalui ngh&n(ian rdarahan &nggumalan darah

    K!m!n&n +ang '&r&ran dalamh&m!s(asis*$r!m'!si(

    Km!n&n lasma darah +g '&rariasi

    Dinding &m'uluh darah

    Rngksan M&kanism& H!m&!s(asisRngksan M&kanism& H!m&!s(asis

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    gg

    ' i

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    $r!m'!si(

    $rm'!si( 'rran dlm mm'n(uksum'a( h&m!s(a(ik a)al d m'luhdarah k&,il (r!m'us a)al d ar(&ri

    &naAk(1(as (rm'!si( d( dis(imulasi !9*Ag&n kimia

    ADP /(r!m'!si(0 &ri(r!si(0 s&l-s&l &nd!(&lial2 Ein&1rin0 k!lag&n0 (r!m'in dan PA"

    K!ml&ks imun

    $rauma 1isik

    k i1i ' i

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    Ak(i1i(as (r!m'!si(

    Ak(i1asi (r!m'!si( diiku(i !l&h'&'&raa 1&n!m&na*Pr'han 'n(uk (rm'!si( dr 'n(uk ,akram

    m%adi s1&ris dngn s&ud!!dia0+g mm1sili(asi(r%dn+a agr&gasi ak(i1i(as k!agulasi

    Plsan ''ra kmn&n +g (rli'a( dlmh&m!s(asis +g dihsilkan !9 granul in(ras&lulars&&r(i ADP0s&r!(!nin0$QA>0 "

    Agr&gasi

    Ad&si ada dinding &m'uluh darah

    M&kanism& P&m'&kuan DarahM&kanism& P&m'&kuan Darah

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    M&kanism& P&m'&kuan DarahM&kanism& P&m'&kuan Darah

    "ak(!r3 &m'&kuan darah"ak(!r3 &m'&kuan darah

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    "ak(!r3 &m'&kuan darah"ak(!r &m'&kuan darah

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    Klasi1ikasi 1ungsi!nal 1ak(!r-1ak(!rKlasi1ikasi 1ungsi!nal 1ak(!r-1ak(!r

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    Klasi1ikasi 1ungsi!nal 1ak(!r 1ak(!rKlasi1ikasi 1ungsi!nal 1ak(!r 1ak(!r

    &m'&kuan darah&m'&kuan darah

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    Klasi1ikasi 1ungsi!nal 1ak(!r-1ak(!rKlasi1ikasi 1ungsi!nal 1ak(!r-1ak(!r

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    &m'&kuan darah&m'&kuan darah

    K&adaan a(!l!gis +ang '&rhu'unganK&adaan a(!l!gis +ang '&rhu'ungan

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    K&adaan a(!l!gis +ang '&rhu'unganK&adaan a(!l!gis +ang '&rhu'ungan

    d&ngan m&kanism& &m'&kuan darahd&ngan m&kanism& &m'&kuan darah

    H&m!1ilia AD&1isi&nsi 1ak(!r III

    P&n+aki( Q-,hr!m!s!m&-link&d

    H&m!1ilia BD&1isi&nsi 1ak(!r IQ

    P&n+aki( !n ill&'randD&1isi&nsi 1ak(!r !n ill&'rand /"20

    1ak(!r +ang m&mi,u adh&si (r!m'!si( ada&m'uluh darah +ang m&ngalami in%uri

    HEMOGLOBIN

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    HEMOGLOBIN

    $u%uan P&m'&la%aran

    P&ndahuluan

    S(ruk(ur H&m!gl!'in

    "ungsi H&m!gl!'in

    K!r&lasi KlinikK&simulan

    $u%uan P&m'&la%aran

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    $u%uan P&m'&la%aran

    S&(&lah m&ngiku(i dan m&m&la%arikuliah ini mahasis)a daa(*

    M&mahami s(ruk(ur h&m!gl!'in

    M&mahami 1ungsi h&m!gl!'in

    P&ndah l an

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    P&ndahuluan

    H&m&r!(&insH&m!gl!'in

    M+!gl!'in

    Prin,iall+ r&la(&d (! (h&ir

    a'ili(+ (! 'ind m!l&,ular!+g&n

    S( k( H l 'i

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    S(ruk(ur H&m!gl!'in

    Adul( h&m!gl!'in is a (&(ram&ri,h&m&r!(&in /uar(&n&r+ s(ru,(ur&21!und in &r+(hr!,+(&s )h&r& i( isr&s!nsi'l& 1!r 'inding !+g&n in (h&lung and (rans!r(ing (h& '!und !+g&n(hr!ugh!u( (h& '!d+ )h&r& i( is us&d ina&r!'i, m&(a'!li, a(h)a+s

    $h& (&(ram&rs ar& ,!m!s&d !1 airs !1()! di11&r&n( !l+&(id& su'uni(s

    $h& su'uni(s ar& -0 T-0 -0 U-,hain

    K i i ' i( h l 'iK!m!sisi s ' ni( h&m!gl!'in

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    K!m!sisi su'uni( h&m!gl!'inK!m!sisi su'uni( h&m!gl!'inH&m!gl!'in d&)asa n!rmal /H'A2 >>

    H&m!gl!'in 1&(al >T>

    H&m!gl!'in si,kl& ,&ll >S>

    H&m!gl!'in d&)asa /min!r9H'A>2

    >U>$h& !&rall h&m!gl!'in ,!m!si(i!n in a

    n!rmal adul( is ar!ima(&l+ .67H'A0 >7 H'A>and C.67 H'"

    Ilus(rasi s(ruk(ur H'Ilus(rasi s(ruk(ur H'

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    Ilus(rasi s(ruk(ur H'us( as s( u (u '

    $h& ha&m!gl!'in m!l&,ul& is a (&(ram&r ,!nsis(ing !1 5!l+&(id& ,hains0 kn!)n as gl!'ins0 )hi,h ar& usuall+*> alha ,hains (ha( ar& &a,h 5 amin! a,ids l!ng> '&(a ,hains (ha( ar& &a,h 5 amin! a,ids l!ng

    A((a,h&d (! &a,h ,hain is an ir!n-,!n(aining m!l&,ul&

    Ilus(rasi s(ruk(ur H'Ilus(rasi s(ruk(ur H'

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    Ilus(rasi s(ruk(ur H'Ilus(rasi s(ruk(ur H'

    "ungsi H&m!gl!'in"ungsi H&m!gl!'in

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    "ungsi H&m!gl!'inu gs & !g !'

    $ * (&ns&R * r&la&d

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    M&(a'!lism& B&siM&(a'!lism& B&si

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    M&(a'!lism& B&siM&(a'!lism& B&si

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    Teri!a Kasih