Korelasi Dosis Kumulatif Siklofosfamid Dengan Kadar Follicle Stimulating Hormone Pada Penderita Systemic Lupus Erythematosus Dewasa Di RSUP DR.Sardjito

Nursandi Margodita, Dr. dr. Deddy Nur Wachid A., M.Kes.,SpPD.,K-R ; Dr. dr. Ayu Paramaiswari., SpPD.,K-R

2025 | Tesis-Spesialis | S2 Ilmu Penyakit Dalam

Pendahuluan: Systemic Lupus Erythematosus (SLE) merupakan penyakit autoimun multisistem yang sering menyerang wanita usia reproduktif. Siklofosfamid (CYC) merupakan salah satu terapi utama pada SLE berat, namun diketahui memiliki efek samping gonadotoksik yang dapat menurunkan fungsi ovarium.

Tujuan: Mengetahui korelasi antara dosis kumulatif siklofosfamid dengan kadar Follicle Stimulating Hormone (FSH) sebagai indikator fungsi ovarium pada pasien SLE dewasa di RSUP Dr. Sardjito Yogyakarta.

Metode: Penelitian ini merupakan studi analitik observasional dengan rancangan potong lintang (cross-sectional). Subjek penelitian adalah pasien SLE dewasa yang mendapat terapi siklofosfamid dan memenuhi kriteria inklusi–eksklusi. Data dosis kumulatif siklofosfamid diperoleh dari rekam medis, sedangkan kadar FSH diambil dari hasil pemeriksaan laboratorium. Analisis hubungan dilakukan menggunakan uji korelasi Spearman.

Hasil: Dari 40 subjek yang memenuhi kriteria, didapatkan nilai korelasi positif antara dosis kumulatif siklofosfamid dan kadar FSH (r = 0,629; p = 0,001), yang menunjukkan semakin tinggi dosis kumulatif siklofosfamid maka kadar FSH juga meningkat.

Kesimpulan: Terdapat korelasi positif yang bermakna antara dosis kumulatif siklofosfamid dan kadar FSH pada pasien SLE dewasa. Peningkatan kadar FSH mengindikasikan adanya penurunan fungsi ovarium akibat paparan kumulatif siklofosfamid.

 

Background: Systemic Lupus Erythematosus (SLE) is a multisystem autoimmune disease that predominantly affects women of reproductive age. Cyclophosphamide (CYC) is one of the main therapeutic agents for severe SLE; however, it has a known gonadotoxic effect that may impair ovarian function.

Objective: This study aimed to determine the correlation between the cumulative dose of cyclophosphamide and the level of Follicle Stimulating Hormone (FSH) as an indicator of ovarian function in adult SLE patients at Dr. Sardjito General Hospital, Yogyakarta.

Methods: This was an analytical observational study with a cross-sectional design. The study included adult SLE patients who received cyclophosphamide therapy and met the inclusion and exclusion criteria. The cumulative dose of cyclophosphamide was obtained from medical records, while serum FSH levels were retrieved from laboratory data. The correlation between cumulative cyclophosphamide dose and FSH level was analyzed using the Spearman correlation test.

Results: A total of 40 subjects met the inclusion criteria. The study demonstrated a strong positive correlation between the cumulative dose of cyclophosphamide and serum FSH levels (r = 0.629; p = 0.001), indicating that higher cumulative doses of cyclophosphamide were associated with elevated FSH levels.

Conclusion: There is a significant positive correlation between the cumulative dose of cyclophosphamide and FSH levels in adult SLE patients. The increase in FSH levels suggests a decline in ovarian reserve associated with cumulative cyclophosphamide exposure.

 

Kata Kunci : Kata kunci: Systemic Lupus Erythematosus (SLE), Siklofosfamid, Dosis Kumulatif, Follicle Stimulating Hormone (FSH), Fungsi Ovarium