Korelasi Kadar Prothrombin fragment 1+2 (F1+2) dan D-Dimer pada Trombosis Vena Dalam

ANDINA DYAHAYUNING R, Dr. dr. Usi Sukorini, M.Kes., Sp.PK(K); Dr. dr. Teguh Triyono, M.Kes, Sp.PK (K)

2019 | Tesis-Spesialis | PATOLOGI KLINIK

Latar belakang: Hiperkoagulasi yang mengawali terjadinya trombus pada trombus vena dalam (TVD) dapat tercermin dari peningkatan F1+2. Secara teori peningkatan F1+2 akan diikuti dengan peningkatan D-Dimer. Prothrombin fragment 1+2 belum pernah digunakan sebagai penanda adanya trombus walaupun F1+2 merupakan penanda yang lebih awal terbentuk dibandingkan D-Dimer. Peneliti ingin mengetahui apakah terdapat korelasi antara F1+2 dengan D-Dimer? Tujuan: Mengetahui korelasi antara F1+2 dan D-Dimer pada pasien TVD. Metode: Penelitian ini merupakan penelitian potong lintang. Subyek penelitian terdiri dari 40 pasien TVD. Subyek yang didapatkan diperiksa kadar F1+2 dengan metode sandwich enzyme immunoassay dan D-Dimer dengan metode latex enhanced photometric immunoassays. Selain itu subyek dikelompokkan berdasarkan ada dan tidaknya faktor risiko tertentu. Hasil: Subyek TVD wanita (77,5%) lebih banyak dibandingkan pria (22,5%). Rerata usia pasien TVD 53,1 ± 12 tahun. Indeks massa tubuh (IMT) pasien TVD 21,671 ± 4,506 kg/m2. Pasien TVD terdiri dari pasien kanker (52,5%), hipertensi (45%), tirah baring lebih dari 3 hari (30%), Diabetes mellitus (DM) (15%), Congestive heart failure (CHF) (7%), riwayat operasi (7%), kontrasepsi hormonal (2,5%). Subyek kanker terdiri dari kanker serviks (30%), kanker ovarium (30%), kanker payudara (10%), kanker endometrium, paru, kolon, prostat, hepatoseluler, lidah (masing-masing 5%). Terdapat korelasi yang positif (r = 0,325) antara F1+2 dan D-Dimer (p = 0,041, (p < 0,05)). Simpulan: Terdapat korelasi positif antara Prothrombin fragment 1+2 dan D-Dimer (r = 0,325) pada pasien trombosis vena dalam. Hasil penelitian ini diharapkan F1+2 dapat sebagai penanda status hiperkoagulabilitas pada TVD.

Background: Hypercoagulation that initiates thrombus in deep vein thrombosis (DVT) can be reflected in an increase in F1+2. Prothrombin fragment 1 + 2 is an active peptide derived from the breakdown of prothrombin to thrombin. Prothrombin fragment 1+2 has never been used as a marker for thrombus even though F1+2 is a marker that is earlier established than D-Dimer. Researchers want to know whether there is a correlation between F1+2 and D-Dimer?. Aim: Determine the correlation between F1+2 and D-Dimers in DVT patients. Methods: This is a cross sectional study. The subjects of this study consisted of 40 DVT patients. The subjects obtained were examined the levels of F1+2 with sandwich enzyme immunoassay and D-Dimer with latex enhanced photometric immunoassays method. In addition the subjects are grouped based on the presence or absence of certain risk factors. Results: Female DVT subjects (77.5%) were more than men (22.5%). The mean age of DVT patient was 53.1 ± 12 years. Body mass index of DVT patients 21,671 ± 4,506 kg/m2. DVT patients consisted of cancer patients (52.5%), hypertension (45%), bed rest more than 3 days (30%), Diabetes mellitus (DM) (15%), Congestive heart failure (CHF) (7%), history of surgery (7%), hormonal contraception (2.5%). Cancer subjects consisted of cervical cancer (30%), ovarian cancer (30%), breast cancer (10%), endometrial, lung, colon, prostate, hepatocellular cancer, tongue (5% each). Level of F1+2 is 0,479 (0,17-2,00) nmol/L and D-Dimer is 1174,5 (144-26240) ng/mL. There is a positive correlation (r = 0.325) between F1+2 and D-Dimer level (p = 0.041, (p <0.05)). Conclusion: There was a positive correlation between Prothrombin fragment 1+2 and D-Dimer (r = 0,331) in patients with deep vein thrombosis. The results of this study are expected to be F1 + 2 as a marker of hypercoagulability status in TVD.

Kata Kunci : trombosis vena dalam, Prothrombin fragment 1+2, D-Dimer