Korelasi Kadar hsCRP dengan gangguan kognitif pada pasien stroke iskemik akut

FAJAR PRABOWO, Prof. Dr. dr. Sri Sutarni, Sp. S(K); dr. Astuti, Sp. S(K)

2017 | Tesis-Spesialis | SP ILMU PENYAKIT SYARAF

Kejadian gangguan kognitif secara akut pada penderita stroke terjadi sekitar 80% pasien kemudian diantaranya 38-73% menjadi menetap. Peningkatan penanda inflamasi sebagai respon inflamasi stroke berhubungan terhadap luaran yang buruk pada pasien stroke. Kadar hsCRP merupakan salah satu yang dapat menjadi prediktor gangguan kognitif vaskular pada pasien stroke infark. Penelitian ini bertujuan untuk mengetahui korelasi kadar hsCRP dalam menentukan terjadinya gangguan fungsi kognitif pada pasien stroke iskemia akut di RSUP Sardjito Yogyakarta. Rancangan penelitian observasional kohort prospektif, dengan subjek pasien serangan stroke iskemia akut pertama. Gangguan kognitif dinilai menggunakan skor MoCA Ina. Kadar hsCRP diperiksa di laboratorium Pramita pada onset <72 jam. Seluruh data kemudian diolah untuk analisis statistik secara komputerisasi. Sebanyak 30 subjek mengikuti penelitian dengan rerata usia 61,93±11,916 tahun dan kadar hsCRP 3.35 ± 2.23 g/dL. Hasil analisis bivariat didapatkan 1 faktor bermakna secara signifikan mempengaruhi gangguan kognitif pasien stroke iskemia yaitu kadar hsCRP (r =-0,538, p =0,002)). Setelah dilakukan analisis multivariat menunjukkan bahwa kadar hsCRP (β =-0,5, p =0,003) merupakan faktor independen yang mempengaruhi gangguan kognitif stroke iskemia akut. Berdasarkan penelitian ini, terdapat korelasi kadar hsCRP dengan ganguan kognitif stroke iskemia akut. yaitu kadar hsCRP yang lebih tinggi memiliki nilai MoCA Ina semakin rendah.

The incidence of acute cognitive impairment in stroke patients occurred in about 80% of patients and 38-73% of them became impaired permanently. The Increased inflammatory markers as a response to stroke inflamation are associated with poor outcomes in stroke patients. HsCRP level is one of the vascular cognitive impairment predictor in infarction stroke patients. This study aims to determine the correlation of hsCRP levels in determining the occurrence of cognitive function disorder in patients with acute ischemic stroke at RSUP Sardjito Yogyakarta. The design was prospective cohort observational study,with the subject of the first acute ischemic stroke patients. Cognitive impairment was assessed using the MoCA Ina score. The hsCRP level was examined in the Pramita laboratory at onset <72 h. All data was processed with computerized statistical analysis. A total of 30 subjects followed the study with mean age 61.93 ± 11.916 years and hsCRP levels of 3.35 ± 2.23 g/dL. The result of bivariate analysis showed that one factor significantly influence cognitive impairment of ischemic stroke patients, that is hsCRP levels (r= -0,538, p= 0,002)). Multivariate analysis showed that hsCRP levels (β= -0.5, p= 0.003) were independent factors affecting cognitive impairment of acute ischemic stroke. Based on this study, there is a correlation between hsCRP levels with acute ischemic stroke cognitive impairment, that is, the higher hsCRP levels, the lower MoCA Ina values.

Kata Kunci : hsCRP, MoCA Ina, gangguan kognitif, stroke iskemia