Rahmawati (2014) Analisis Kadar Monocyte Chemoattractant Protein-1 Urine pada Aktifitas Penyakit, Derajat Kekambuhan dan Terjadinya Kekambuhan Nefritis Lupus di RSSA Malang (Penelitian Longitudinal). Magister thesis, Universitas Brawijaya.
Abstract
Latar Belakang. Nefritis lupus (NL) merupakan manifestasi serius pada lupus eritematosus sistemik (LES). Pemeriksaan urinalisis memiliki sensitivitas dan spesifisitas yang kurang untuk membedakan aktivitas dan derajat kekambuhan NL. Penelitian berbagai biomarker untuk menilai aktivitas dan derajat kekambuhan NL, diantaranya adalah monocyte chemoattractant protein-1 urine (uMCP-1). Tujuan penelitian untuk mengetahui apakah uMCP-1 dapat digunakan untuk menilai aktivitas penyakit, derajat kekambuhan dan terjadinya kekambuhan NL. Metode Penelitian. Penelitian dilakukan di RS Dr. Saiful Anwar Malang, diagnosis LES ditegakkan berdasarkan kriteria ARA 1997 dan NL berdasarkan adanya gangguan ginjal menurut ACR. Sampel diambil longitudinal selama 6 bulan. Aktivitas penyakit berdasarkan renal domain SLEDAI score dibagi 2 kelompok aktif dan tidak aktif. Derajat kekambuhan berdasarkan Ohio SLE study (OSS) menjadi 3 kelompok yaitu ringan, sedang dan berat. Pemeriksaan urine lengkap, ureum dan kreatinin dilakukan selama 6 bulan. Kadar uMCP-1 ditentukan dengan metode ELISA dari sampel urine sewaktu. Hasil. Pada penelitian didapat hasil kadar uMCP-1 lebih tinggi pada kelompok NL yang aktif dibanding yang tidak aktif. Secara statistik didapatkan perbedaan yang bermakna kadar uMCP-1 antara kelompok NL yang aktif dan tidak aktif dengan p = 0,004. Hasil uji korelasi antara kadar uMCP-1 dengan renal domain terdapat hubungan yang bermakna p 0,001 dengan kekuatan hubungan sedang (r = 0,532) dan arah hubungan yang positif. Kadar uMCP-1 pada penderita NL yang kambuh lebih tinggi dibandingkan NL yang tidak kambuh, dengan hasil analisis statistik didapatkan perbedaan yang bermakna dengan nilai p = 0,001. Analisis risiko kekambuhan NL dengan peningkatan kadar uMCP-1 didapatkan hasil yang bermakna pada peningkatan dari cutoff point (29,38 ng/ml) dengan nilai p = 0,008, risiko relatif (RR) 2,148 kali dengan sensitivitas dan spesifisitas 65,6% dan 64,2%. Kesimpulan. Terdapat perbedaan bermakna kadar uMCP-1 pada aktivitas penyakit NL yang aktif dan tidak aktif serta terdapat hubungan yang bermakna kadar uMCP-1 dengan renal domain SLEDAI score . Kadar uMCP-1 pada derajat kekambuhan NL juga didapatkan perbedaan yang bermakna dengan analisis risiko terjadi kekambuhan NL pada peningkatan kadar uMCP-1 dari cutoff point .
English Abstract
Background. Lupus nephritis (NL) is a serious manifestation of systemic lupus ery matosus (SLE). Urinalysis examination has a less sensitivity and specificity to differentiate activity and degree of NL flare. re are various biomarkers to assess activity and degree of NL flare, including urine monocyte chemoattractant protein - 1 (uMCP - 1). purpose of study is to determine use of uMCP - 1 to assess disease activity, degree and events of NL flare. Methods. study was conducted at Dr. Saiful Anwar Malang General Hospital, diagnosis of SLE was based on criteria of ARA 1997 and NL was determined based on presence of renal dysfunction according to ACR. Samples were taken consecutively for 6 months. Disease activity was determined by renal domain SLEDAI score, and classified into of active and inactive groups. degree of flare was based on Ohio SLE study ( OSS ) n classified into 3 groups: mild, moderate and severe. Urinalysis, urea and creatinine were consecutively examined for 6 months. uMCP-1 levels were examined by ELISA method in random urine spesimen. Results. In this research we found that uMCP-1 levels were higher in active group than inactive NL. re was a significant difference in uMCP-1 levels between groups NL active and inactive with p = 0.004. Correlation test showed significant correlation between uMCP-1 levels with renal domain with p 0.001 and strength of correlation was moderate (r = 0.532) and positively related. uMCP-1 levels in patients with NL flare were higher than non flare NL, difference was significant with p = 0.001. Analysis of risk of NL flare with elevated levels uMCP-1 were significant in increase from cutoff point (29.38 ng/ml ) with p = 0.008, relative risk (RR) 2.148 fold, sensitivity and specificity was 65.6% and 64.2%. Conclusion. re were significant differences in levels of uMCP-1 in disease activity of NL active and inactive, and re was a significant correlation with levels of uMCP-1 with renal domain SLEDAI score. uMCP-1 levels in degree of NL flare was differently significant in risk of NL flare analysis which occurs at elevated levels uMCP-1 from cutoff point.
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/616.772/RAH/a/041404860 |
| Subjects: | 600 Technology (Applied sciences) > 616 Diseases > 616.7 Diseases of musculoskeletal system |
| Divisions: | Profesi Kedokteran > Spesialis Patologi Klinik, Fakultas Kedokteran |
| Depositing User: | Endro Setyobudi |
| Date Deposited: | 10 Sep 2014 09:30 |
| Last Modified: | 10 Sep 2014 09:30 |
| URI: | http://repository.ub.ac.id/id/eprint/158412 |
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