Hubungan Antara Kadar Amonia Serum dengan Komplikasi Ensefalopati Hepatik pada Pasien Sirosis Hati.

Maharani, Aliyya Clarisa and Dr. dr. Nur Samsu, Sp.PD, K-GH and Dr. dr. Supriono, Sp.PD, K-GEH, FINASIM (2024) Hubungan Antara Kadar Amonia Serum dengan Komplikasi Ensefalopati Hepatik pada Pasien Sirosis Hati. Sarjana thesis, Universitas Brawijaya.

Abstract

Organ hati yang sehat memiliki fungsi detoksifikasi dengan melakukan metabolisme amonia dan mengubahnya menjadi urea untuk kemudian diekskresi melalui urin, sehingga mencegah masuknya amonia ke dalam sirkulasi sistemik. Oleh karena itu, kerusakan hati secara kronik seperti pada penyakit sirosis hati dapat berkonsekuensi meningkatkan kadar amonia dalam sirkulasi sistemik, yang diduga menyebabkan komplikasi Ensefalopati Hepatik (EH). Penelitian ini bertujuan untuk mengetahui dan menganalisis hubungan antara kadar amonia serum dengan komplikasi ensefalopati hepatik. Subjek penelitian merupakan pasien sirosis hati di RSUD Saiful Anwar Malang sejumlah 57 pasien yang kemudian dibagi menjadi 3 kelompok menurut penilaian observasi klinis dan uji psikometrik, yaitu tanpa EH, EH covert, dan EH overt. Studi potong-lintang ini melakukan pengambilan sampel amonia serum dari subjek penelitian secara acak dan independen. Secara karakteristik, pasien sirosis hati subjek penelitian ini didominasi oleh jenis kelamin laki-laki, rerata usia subjek 58,2 ± 10,68 tahun, mayoritas lama sekolah 12 tahun, etiologi terbanyak adalah hepatitis B, serta lama pengobatan kebanyakan adalah 1-5 tahun. Dari hasil penelitian, analisis nilai kadar amonia serum pada ketiga kelompok menunjukkan perbedaan yang bermakna dengan nilai p=0,000 (nilai signifikan p<0,05) pada uji One Way ANOVA, dilanjutkan dengan uji Post Hoc Least Significant Difference (LSD) menunjukkan terdapat perbedaan yang signifikan antara kelompok tanpa EH dengan EH overt (p=0,000), serta antara kelompok EH covert dengan EH overt (p=0,003). Namun, tidak ada perbedaan signifikan antara kelompok tanpa EH dengan EH covert (p=0,058). Dengan demikian, dapat disimpulkan bahwa terdapat hubungan antara kadar amonia serum dengan komplikasi ensefalopati hepatik, dan semakin tinggi peningkatan kadar amonia serum, maka semakin besar derajat keparahan ensefalopati hepatik yang ditimbulkan.

English Abstract

A healthy liver has a detoxification function by metabolizing ammonia and converting it into urea to be excreted through urine, thereby preventing the entry of ammonia into the systemic circulation. Therefore, chronic liver damage such as liver cirrhosis can have the consequence of increasing ammonia levels in the systemic circulation, which is thought to cause complications of Hepatic Encephalopathy (HE). This study aims to determine and analyze the relationship between serum ammonia levels and the hepatic encephalopathy complication. The research subjects were liver cirrhosis patients at Saiful Anwar Hospital Malang which is 57 patients, who were then divided into 3 groups according to assessment of clinical observation and psychometric tests, namely without HE, covert HE, and overt HE. This cross-sectional study carried out sampling of serum ammonia from research subjects randomly and independently. Characteristically, the liver cirrhosis patients in this study were predominantly male, the average age of the subjects was 58.2 ± 10.68 years, the majority had 12 years of schooling, the most common etiology was hepatitis B, and the duration of treatment was mostly 1-5 years. From the research results, analysis of serum ammonia levels in the three groups showed a meaningful difference with p=0.000 (significant value p<0.05) in the One Way ANOVA test, followed by the Post Hoc Least Significant Difference (LSD) test showing that there were significant differences between groups without HE and overt HE (p=0.000), as well as between the covert HE and overt HE groups (p=0.003). However, there was no significant difference between the group without HE and covert HE (p=0.058). Thus, it can be concluded that there is a relationship between serum ammonia levels and the hepatic encephalopathy complication, and the higher of increase in serum ammonia levels, the greater severity grade of hepatic encephalopathy occured.

Item Type:	Thesis (Sarjana)
Identification Number:	0524060076
Uncontrolled Keywords:	Amonia, Ensefalopati hepatik, Sirosis hati
Divisions:	Fakultas Kedokteran > Pendidikan Dokter
Depositing User:	Endang Susworini
Date Deposited:	13 Feb 2024 06:07
Last Modified:	13 Feb 2024 06:07
URI:	http://repository.ub.ac.id/id/eprint/215057

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