Putrianti, Rachmi Mirna and Dr. dr. Ery Olivianto, Sp.A (K) and dr. Indrastuti Normahayu, Sp. Rad (K) (2023) Korelasi Antara Kadar Serum Monocyte Hemoattractant Protein 2 (Mcp-2) Dengan Derajat Keparahan Tuberkulosis Berdasarkan Gambaran Foto Toraks. Magister thesis, Universitas Brawijaya.
Abstract
Latar Belakang dan Tujuan : Tuberkulosis (TB) merupakan masalah kesehatan masyarakat di seluruh dunia, merupakan salah satu penyebab kematian pada anak. Salah satu permasalahan TB anak di Indonesia adalah penegakan diagnosis aktif dan laten. Akan tetapi, populasi basil TB pada anak rendah dan spesimen dari pemeriksaan juga sulit didapatkan. Gambaran radiologis pada anak memiliki karakteristik khas yang dapat dijadikan dasar diagnosis Dalam pathogenesis TB aktif dan laten banyak senyawa biologis yang berperan. Molekul biologis yang berperan dalam inflamasi sebagai respon terhadap Mtb yang bereplikasi, antara lain Monocyte Chemoatractant Protein-2 (MCP-2). Sejauh ini penggunaan MCP-2 sebagai penanda biologis TB telah banyak diteliti pada pasien dewasa namun belum digunakan secara luas terutama pada pasien TB paru anak. Oleh karena itu penelitian ini bertujuan untuk mengetahui korelasi antara kadar serum MCP-2 dengan derajat keparahan TB berdasarkan gambaran Foto Toraks. Metode Penelitian: Penelitian ini menggunakan rancangan studi analisis. Subjek penelitian adalah pasien anak usia ≤ 18 tahun dengan dugaan TB dan belum pernah menjalani pengobatan TB yang diperiksa di RSUD Saiful Anwar Malang serta memenuhi kriteria inklusi dan eksklusi. dengan konsekutif sampling 60 subjek kemudian dilakukan analisa kadar serum MCP-2 dengan Metode ELISA. Data dikelompokkan menjadi 2 variabel non TB dan TB. dan dikelompokkan menjadi 3 foto thorax ringan, sedang, dan berat, setelah itu dilakukan uji statistik yaitu uji normalitas dan homogenitas dan uji korelasi. Uji statistic dikatakan bermakna jika p value < 0.05. semua analisis data dilakukan menggunakan software SPSS versi 2.3. IBM Chicago. Hasil Penelitian : dari 60 subjek, 30 subjek TB; jenis kelamin dominan laki laki 36 subjek; dengan berat badan sangat kurang 17 subjek; skoring TB pada pasien TB >6 27 subjek; TCM rif sensitive 16 subjek; TB paru 22 subjek; berdasar foto thorax dominan derajat sedang 18 subjek, kadar MCP-2 pada TB 202,3 pg/dl (102,3-692,03), berdasar uji beda dengan mann whitney, Kadar perbedaan MCP-2 dengan TB bermakna P=0,000, keparahan foto thorax dengan kadar MCP-2 derajat ringan 167,97pg/dl (102,3-568,62) sedang 284,49 pg/dl (233,36-321,71) berat 594,12 pg/dl (439,07-692,03) signifikan antara kelompok P=0,000 Kesimpulan : Terdapat perbedaan kadar MCP-2 pada pasien non TB dan TB, serta terdapat korelasi antara kadar MCP-2 dengan derajat keparahan TB anak.
English Abstract
Background and Objectives: Tuberculosis (TB) is a public health problem worldwide, conjuction to the causes of death in children, either problems of Child Tuberculosis are to diagnose active or latent TB. However, the population of bacil tuberculose in children is low and specimens from examinations are also difficult to obtain. Radiological features in children have distinctive characteristics that can be used as basis for diagnosis. In the pathogenesis of active and latent TB, many biological compounds play a role. Biological molecules that play a role in inflammation as response to replicating Mtb, including Monocyte Chemoatractant Protein-2 (MCP-2). To this extent the use of MCP-2 as a TB biomarker has been widely studied in adult patients but has not been used extensively, especially in Child tuberculosis. Therefore, this study aims to determine the relationship between MCP-2 levels with severity of TB in children based on radiological features. Methods: This study uses an analytical study design. The research subjects were pediatric patients aged <18 years with suspected TB and had never undergone TB treatment who were examined at Saiful anwar malang Hospital and met the inclusion and exclusion criteria with consecutive sampling of 60 subjects then analyzed serum levels of MCP-2 with ELISA method. The data is grouped into 2 non-TB and TB variables. And grouped into 3 mild, moderate and severe chest photos, after which statistical test were carried out, namely normality and homogeneity test and correlation test. The statistical tests is said to be significant if the p valkue <0,05. All data analysis was performed using SPSS software version 2.3 IBM Chicago. Result: 60 subjects, 30 TB subjects; dominant male 36 subjects; less body weight 17 subjects; TB scoring >6 27 subjects; TCM rif sensitive 16 subjects; Pulmonary TB 22 subjects; moderate severity based on chest X-ray 18 subjects, MCP-2 levels in TB were 202,3 pg/dl (102,3-692,03). Based on the difference test with mann whitney, MCP-2 level distinction compared with severity of TB were significant P=0,000, based on the severity of the chest X-ray, with mild degree of MCP-2 level167,97 pg/dl (102,3-568,62) moderate 284,49pg/dl (233,36-321,71) severe 594,12 pg/dl (439,07-692,03) significant between groups P=0,000 Conclusion: There are differences in MCP-2 levels in non-TB and TB patients, and there is a correlation between MCP-2 levels and the severity of TB in children.
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | 0423060091 |
| Uncontrolled Keywords: | Child Tuberculosis, MCP-2, Monocyte Chemoatractant Protein-2, Chest X-ray, biological marker. |
| Subjects: | 600 Technology (Applied sciences) > 618 Gynecology, obstetrics, pediatrics, geriatrics > 618.4 Childbirth |
| Divisions: | Profesi Kedokteran > Spesialis Ilmu Kesehatan Anak, Fakultas Kedokteran |
| Depositing User: | Endang Susworini |
| Date Deposited: | 08 Dec 2023 09:01 |
| Last Modified: | 08 Dec 2023 09:01 |
| URI: | http://repository.ub.ac.id/id/eprint/205150 |
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