PERBEDAAN KADAR GLIAL FIBRILLARY ACIDIC PROTEIN (GFAP) SERUM PADA STROKE HEMORAGIK DAN STROKE ISKEMIK DI RSUP DR. SARDJITO YOGYAKARTA

SITI ENDAH S, dr. Setyawati, SpPK(K); dr. Windarwati, MSc., SpPK(K)

2015 | Tesis-Spesialis | SP ILMU PATOLOGI KLINIK

Stroke merupakan salah satu penyebab kematian dan kecacatan neurologis yang utama di Indonesia. Stroke dibagi menjadi stroke iskemik dan stroke hemoragik, membedakan keduanya adalah langkah penting dalam penatalaksanaan stroke akut karena secara prinsip penatalaksanaannya berbeda. Cara yang paling akurat untuk membedakannya dengan pemeriksaan Computerized Tomography (CT) Scan otak. Glial Fibrillary Acidic Protein merupakan protein yang sangat spesifik untuk otak (Highly Brain Spesific Protein) yang tidak dihasilkan sel lain di luar SSP. Penelitian ini merupakan penelitian observasional analitik dengan desain potong lintang untuk mengetahui perbedaan kadar GFAP pasien stroke hemoragik dan stroke iskemik di RSUP Dr. Sardjito Yogyakarta. Subyek penelitian adalah 30 pasien stroke akut yang yang datang ke IGD atau Unit Stroke yang dipilih secara berurutan dan memenuhi kriteria inklusi maupun eksklusi periode Februari-April 2015 dan dibedakan menjadi stroke hemoragik dan stroke iskemik berdasarkan hasil pemeriksaan CT-Scan atau MRI. Kadar GFAP diperiksa dengan metode ELISA sandwich. Median kadar GFAP serum stroke hemoragik 2,94 ng/mL (0,1-26,04) dan stroke iskemik 0,1 ng/mL (0,03-0,20). Kadar GFAP serum stroke hemoragik lebih tinggi signifikan dibanding stroke iskemik.

Stroke was one of the causes of death and major neurological disability in Indonesia. Stroke was divided into ischemic and hemorrhagic stroke, distinguishes them was an important step in the management of acute stroke due to its management principle differently. The most accurate way to differentiate them was the examination of Computerized Tomography (CT) scans. Glial Fibrillary Acidic Protein (GFAP) was a protein that was highly spesific for the brain (Brain Highly Specific Protein), was not produced from other cells outside the Central Nervous System (CNS). This was an observational analytic study with a cross-sectional design to know the difference of GFAP level in hemorrhagic and ischemic stroke patients in Dr. Sardjito Hospital Yogyakarta. The subjects consisted of 30 acute stroke patients who came to the Emergency Department or Stroke Unit, consecutive selected and appropriate with the inclusion or exclusion criteria, February-April 2015, devided into hemorrhagic and ischemic stroke based on the results of a CT-scan or MRI. GFAP levels examined with ELISA sandwich method. The median levels of serum GFAP in hemorrhagic stroke 2,94 ng/mL (0,1-26,04) and ischemic stroke 0,1 ng/mL (0,03-0,20). Serum GFAP levels was significantly higher in hemorrhagic than ischemic stroke.

Kata Kunci : stroke akut, hemoragik, iskemik, GFAP