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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
BIOMEDIK I
BIOKIMIA DARAH
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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 $r!m'!si(
K&simulan 16/06/16
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$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( 16/06/16
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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 16/06/16
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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 16/06/16
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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
16/06/16
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 16/06/16
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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. 16/06/16
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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$P16/06/16
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Kar&na (idak m&miliki
mi(!k!ndria0 &ri(r!si( (idakm&mr!duksi A$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
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Sin(&sis > ? 'i1!s1!glis&ra( dlm
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Sin(&sis >0?-'i1!s1!glis&ra( dlm&ri(r!si(
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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
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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. 16/06/16
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( E16/06/16
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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.16/06/16
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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 16/06/16
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
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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!(&in16/06/16
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(ik16/06/16
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 16/06/16
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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
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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
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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&
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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
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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
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$r!m'!si(
$rm'!si( 'rran dlm mm'n(uksum'a( h&m!s(a(ik a)al d m'luhdarah k&,il (r!m'us a)al d ar(&ri
&naAk(1(as (rm'!si( d( dis(imulasi !9*Ag&n kimia
ADP /(r!m'!si(0 &ri(r!si(0 s&l-s&l &nd!(&lial2 Ein&1rin0 k!lag&n0 (r!m'in dan PA"
K!ml&ks imun
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Ak(i1i(as (r!m'!si(
Ak(i1asi (r!m'!si( diiku(i !l&h'&'&raa 1&n!m&na*Pr'han 'n(uk (rm'!si( dr 'n(uk ,akram
m%adi s1&ris dngn s&ud!!dia0+g mm1sili(asi(r%dn+a agr&gasi ak(i1i(as k!agulasi
Plsan ''ra kmn&n +g (rli'a( dlmh&m!s(asis +g dihsilkan !9 granul in(ras&lulars&&r(i ADP0s&r!(!nin0$QA>0 "
Agr&gasi
Ad&si ada dinding &m'uluh darah16/06/16
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
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"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
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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
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HEMOGLOBIN
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HEMOGLOBIN
$u%uan P&m'&la%aran
P&ndahuluan
S(ruk(ur H&m!gl!'in
"ungsi H&m!gl!'in
K!r&lasi KlinikK&simulan
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$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
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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
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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
$h& su'uni(s ar& -0 T-0 -0 U-,hain16/06/16
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K!m!sisi su'uni( h&m!gl!'inK!m!sisi su'uni( h&m!gl!'inH&m!gl!'in d&)asa n!rmal /H'A2 >>
H&m!gl!'in 1&(al >T>
H&m!gl!'in si,kl& ,&ll >S>
H&m!gl!'in d&)asa /min!r9H'A>2
>U>$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'"
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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&16/06/16
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'
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"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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!eri"a Kasih