Hubungan viskositas dan jumlah lekosit cairan sendi dengan intensitas nyeri pada osteoartritis lutut

KHOMIMAH, Dr. Nyoman Kertia, SpPD-KR

2005 | Tesis | PPDS I Ilmu Penyakit Dalam

Latar belakang. Nyeri merupakan keluhan kardinal dan penentu utama hendaya dan gangguan fungsi penderita osteoartritis (OA), terutama penderita usia lanjut. Patogenesis OA dan mekanisme nyeri OA multifaktorial, termasuk proses inflamasi dan nyeri nosiseptif. Analisis cairan sendi dapat digunakan untuk mengetahui adanya inflamasi pada sendi lutut. Adanya inflamasi pada sendi lutut OA dapat menimbulkan dan/atau meningkatkan nyeri pada penderita OA. Tujuan. Mengetahui hubungan antara viskositas dan jumlah lekosit cairan sendi dengan intensitas nyeri pada OA lutut. Metode dan subyek penelitian. Penelitian dilakukan secara potong-lintang, bulan Mei sampai dengan Nopember 2004. Subyek penelitian adalah penderita OA lutut yang berkunjung ke Poliklinik Penyakit Dalam RS Dr Sardjito, memenuhi kriteria penelitian, dan bersedia mengikuti penelitian. Subyek penelitian menjalani wash out satu minggu. Pada saat datang diminta mengisi kuesioner Skala Analog Visual (VAS), dan dilakukan pengambilan cairan sendi lutut. Analisis cairan sendi dilakukan di Patologi Klinik RS Sardjito. Hasil dianalisis dengan uji korelasi Pearson. Hasil. Sebanyak 34 (69,4%) dari 49 subyek penelitian adalah wanita. Rerata usia 61,53 "simbol" 8,28 tahun, 87,8% berusia "simbol" 50 tahun. Sebanyak 85,7% subyek dengan berat badan lebih (IMT "simbol" 23 kg/m2). Pada analisis Pearson, intensitas nyeri berkorelasi positif dengan jumlah lekosit, (r 0,372, p= 0,008) dan berkorelasi negatif dengan viskositas (r –0,294 p=0.040). Pada analisis stepwise regression, setiap peningkatan satu sel lekosit per mm3 diprediksikan meningkatkan intensitas nyeri sebesar 0,016 mm. Jumlah lekosit cairan sendi memberi sumbangan sebesar 13,8% terhadap intensitas nyeri yang terjadi (R2: 0.138 p=0,008). Kesimpulan. Terdapat korelasi antara intensitas nyeri dengan jumlah lekosit dan viskositas cairan sendi penderita OA lutut. peningkatan jumlah lekosit dapat memberikan prediksi peningkatan intensitas nyeri. Jumlah lekosit cairan sendi memberi sumbangan sebesar 13,8% terhadap intensitas nyeri yang terjadi.

Introduce. Pain was the major complain and determined impairment and disability in patients with Osteoarthritis (OA), especially elderly. Pathogenesis of OA and mechanism of pain in OA was multifactorial. One of these was inflammatory process and nociceptif pain. Synovial fluid analyses of patient with knee osteoarthritis revealed presence of inflammatory process. Inflammation at knee OA triggered and or increased pain. Objective. To understand correlation between viscosity and leukocytes count of synovial fluid with pain intensity in knee OA. Methods. The cross sectional design. Subject was patient with OA who came in Internal Medicine outpatient, Sardjito Hospital. They eligible inclusion and exclusion criteria and agreed to participate to this study. Subject performed wash out for a week. At the time, subject filled Visual Analogue scale (VAS) questionnaire according to their pain intensity and Rheumatologist aspirated SF. Sample was analyzed at the Clinical of Laboratories, Sardjito Hospital. The data was analyzed with Pearson. This study was performed in May to November 2004. Results. Of 49 subject whom eligible criteria of study, 34 (69.4%) were female. The mean of age was 61,53 "symbol" 8,28 years old, 87,8% were "symbol" 50 years old. Majority of subjects (85,7%) had overweight (BMI "symbol" 23 kg/m2). In analyzed Pearson Pain intensity had correlation to leucocytes count (r 0,372, p= 0,008) and viscosity of SF (r –0,294 p=0.040). When analyzed by stepwise regression, increase of a leukocyte per mm3 predicted increase 0,016 mm of pain intensity. Leucocytes count of SF contributed 13,8% of pain intensity (R2: 0.138 p=0,008). Conclusion. There were correlation between pain intensity with and viscosity of SF. Increase of leucocytes count of SF could predict increase of pain intensity. Leucocytes count of SF affected to pain intensity as many as 13,8%.

Kata Kunci : Osteoartritis Lutut,Nyeri,Viskositas dan Lekosit Cairan Sendi,knee osteoarthritis,pain,inflammation,synovial fluid