PERBANDINGAN KADAR INTERLEUKIN-6 PADA CAIRAN FOLIKEL OVARIUM PENDERITA ENDOMETRIOSIS DAN WANITA NORMAL

Anggrahenie Prima Diana, dr. Shinta Prawitasari, M.Kes., SpOG(K).; Dr. dr. Cahyono Hadi, SpOG(K)

2017 | Tesis-Spesialis | S2 Ilmu Kebidanan dan Penyakit Kandungan

Latar belakang: Endometriosis adalah pertumbuhan jaringan (sel-sel kelenjar dan stroma) abnormal mirip endometrium (endometrium like tissue) diluar kavum uterus. Inflamasi dan perubahan sistem imun berperan penting dalam onset dan perkembangan endometriosis. Angka fertilitas wanita dengan endometriosis lebih rendah dibandingkan wanita non endometriosis. Hal ini disebabkan oleh beberapa faktor. Salah satunya adalah folikulogenesis yang abnormal. Peningkatan kadar IL-6 pada folikel preovulasi pasien endometriosis mengakibatkan penurunan aktivitas aromatase. Selanjutnya terjadi penurunan kadar estradiol folikel dan akan menyebabkan masalah infertilitas. Tujuan: Membandingkan kadar interleukin-6 cairan folikel ovarium kelompok endometriosis dan non endometriosis. Serta membandingkan kadar interleukin-6 berdasarkan stadium endometriosis. Rancangan penelitian: Potong lintang. Tempat: RSUP Dr.Sardjito dan RS jejaring (RSUD Sleman dan RSUD Bantul) Bahan dan Cara Kerja: Sampel diambil dari 1 Januari 2015 sampai 30 Juni 2015. Sampel berjumlah 35 untuk kelompok endometriosis dan 35 kelompok kontrol. Diagnosis endometriosis dikonfirmasi dengan pemeriksaan histopatologi. Sampel penelitian disimpan dalam wadah steril dan dikirim ke laboratorium biokimia FK UGM. Selanjutnya dilakukan pemeriksaan kadar IL-6 menggunakan metode ELISA. Hasil: Rata-rata kadar IL-6 cairan folikel ovarium kelompok endometriosis lebih tinggi dibandingkan kelompok kontrol (p=0,000). Semakin rendah indeks masa tubuh maka semakin tinggi kadar IL-6 cairan folikel ovarium. Semakin tinggi stadium endometriosis maka semakin tinggi kadar IL-6 cairan folikel ovarium. Subyek dengan dismenorea memiliki kadar IL-6 cairan folikel ovarium lebih tinggi dibandingkan dengan subyek tanpa dismenorea. IL-6 cairan folikel ovarium mempunyai spesifisitas 86,11 % dan sensitivitas 85,29 % dalam memprediksi endometriosis dengan cut off point sebesar 21,99 pg/ml. Kesimpulan: Rata-rata kadar IL-6 cairan folikel ovarium pasien endometriosis lebih tinggi dibandingkan kontrol (p<0,05). Kadar IL-6 pada endometriosis stadium minimalringan lebih rendah dibandingkanendometriosis stadium sedang-barat.

Background: Endometriosis is abnormal tissue growth (glands and stroma) similar with endometrium (endometrium like tissue) outside uterine cavity. Inflammation and immune system disturbance have a role on endometriosis onset and development. Women fertility rate with endometriosis is lower than normal women. diluar kavum uterus. It is caused by many factors. One of them is abnormal folliculogenesis. Elevated level of IL-6 on ovaran follicle of endometriosis patients cause decreased aromatase activity. This condition will cause decreasing estradiol level and infertility. Objective: To compare IL-6 level of ovarian follicle fluid between endometriosis patients and normal women. And to compare IL-6 level besed on endometriosis stage. Study design: Cross sectional. Setting:Sardjito hospital, Sleman district hospital and Bantul district hospital. Materials and Methods: Sample was taken from January 1 st untill June 30 2015. Samples were divided into two groups consist of 35 endometriosis patients and 35 non endometriosis. Endometriosis diagnosis was confirmed with histopathology examination. Samples were stored in sterile container and sent to biochemistry laboratory of medical faculty GMU. Then sample were examined with ELISA method. Results Mean of IL-6 level in ovarian follicle fluid of endometriosis patients is higher than control (p=0,000) The lower body mass index, the higher the levels of IL-6 ovarian follicular fluid, the higher the stage of endometriosis, the higher levels of IL-6 ovarian follicular fluid, and in subjects with dysmenorrhoea have high levels of IL-6 ovarian follicular fluid is higher than the subjects without dysmenorrhoea.. IL-6 of ovarian follicle fluid has spesificity 86,11 % and sensitivity 85,29 % in predicting endometriosis with cut off point 21,99 pg/ml. Conclusion: Mean of IL-6 level in ovarian follicle fluid of endometriosis patients is higher than control (p<0,05). IL-6 level in minimal to mild stage of endometriosis is lower than in moderate to severe stage.

Kata Kunci : IL-6, endometriosis, cairan folikel ovarium, stadium endometriosis, endometriosis, ovarian follicle fluid, endometriosis stage.