Pengaruh pemberian per oral minyak buah merah (Pandanus conoideus Lam) terhadap kadar protein dalam urin, asam urat dalam darah, dan Endoteliosis Glomerular hewan model preeklamsia Rattus norvegicus strain Wistar

IRAWIRAWAN, Hadi, Prof.Dr. H. Moh. Hakimi, PhD.,Sp.OG

2006 | Tesis | S2 Ilmu Kedokteran Dasar dan Biomedis

Stres oksidatif berperan dalam patogenesis preeklampsia. Stres oksidatif pada sirkulasi sistemik yang dipicu oleh gangguan perfusi pada plasenta merupakan penyebab terjadinya disfungsi endotel. Disfungsi endothel akan menimbulkan gejala klinik preeklampsia seperti proteinuria, hiperurisemia dan gambaran histopatologi endoteliosis glomrular pada ginjal. Pencegahan preeklampsia dengan pemberian antioksidan sejak awal kehamilan memberikan harapan sejak diketahui bahwa stres oksidatif berperan dalam patogenesis preeklampsia. Penelitian ini bertujuan untuk mengkaji pengaruh pemberian minyak buah merah yang banyak mengandung antioksidan α tokoferol dan β-karoten terhadap kadar protein urin, asam urat dan gambaran histopatologi endoteliosis glomerular pada hewan model preeklampsia. Tikus putih strain Wistar 32 ekor hamil hari pertama dibagi menjadi 4 kelompok. Pada hari Ke-6 kehamilan diukur tekanan darah dan proteinuria pretest, mulai hari ke-7 sampai hari ke-20 kehamilan kelompok I diberi aquades, kelompok II, III, dan IV masing-masing diberi minyak buah merah peroral 0.15 ml/hari, 0,3 ml/hari, dan 0,6 ml/hari. Hari ke-7 sampai ke-14 kehamilan semua kelompok diberi stres bising, hari ke-7 sampai ke-20 kehamilan diberi stres overpopulasi. Hari ke-18 kehamilan diberi stres akut dan pengukuran tekanan darah posttest, kemudian hari ke-20 dilakukan pengukuran proteinuria posttest, asam urat dan pembuatan preparat histopatologi endoteliosis glomerular. Hasil penelitian pada kelompok I mengalami peningkatan tekanan darah dan proteinuria. Minyak buah merah dapat mencegah kenaikan proteinuria pada kelompok II, III dan IV. Terdapat perbedaan bermakna (p<0.05) kadar asam urat plasma antara kelompok I dengan kelompok II, III dan IV. Kadar asam urat tertinggi pada kelompok I dengan rata-rata 9.93 mg/dl, sedangkan kadar asam urat plasma pada kelompok II, III, dan IV masing-masing 6.16 mg/dl, 6.07 mg/dl, dan 5.96 mg/dl. Minyak buah merah dapat memperbaiki gambaran endoteliosis glomerular. Pada kelompok I tampak gambaran glomerulus hiperseluler, oklusi lumen arterial dan tak tampak eritrosit sehingga terkesan glomerulus tanpa darah. Pada kelompok II,III dan IV yang mendapat pemberian minyak buah merah dengan tiga variasi dosis tampak gambaran eritrosit mengisi lumen kapiler dan seluleritasnya menurun. Pengujian korelasi bivariat mendapatkan adanya hubungan positif (P<0.01) antara tekanan darah,kadar protein urin dengan kadar asam urat plasma. Dari studi ini dapat disimpulkan bahwa pemberian minyak buah merah dapat mencegah terjadinya peningkatan tekanan darah, proteinuria dan perbaikan endoteliosis glomerular pada hewan model preeklampsia.

Oxidative stress may contribute to the pathogenesis of preeclampsia. Poor placental perfusion could initiate oxidative stress which then become endothelial dysfunction. Endothelial dysfunction could generate preeclampsia symptom such as proteinuria, hyperuricemia, and histopathological glomerular endotheliosis of the kidney. Supplemental antioxidants which are given at earlier pregnancies may make advantage to prevent preeclampsia since the role of oxidative stress in the pathogenesis of preeclampsia. This study is carried out to determine the influence of buah merah with ingredient of α-tocopherol and β-carotene that may change level of protein in urine, uric acid plasma, and depict of histopathological glomerular endotheliosis of the kidney in a wistar rat model for preeclampsia. At the first day of experiment, 32 pregnant rat were randomly divided into 4 groups. On 6th day of pregnancy, pretest measurement of blood pressure and protein in urine. From day 7 until 20 of pregnancy, Group I received distilled water, but Group II, III, and IV were treated with buah merah oil orally at doses of 0,15 ml/day, 0,3 ml/day, 0,6 ml/day each. All of the group were exposed to high level noise (100dB) to generate stressful condition from day 7 until 14 of pregnancy. At the same time, all of them were placed in overpopulated cage from day 7 until 20 of pregnancy. On the day 18, each of rat was exposed to acute stress by placing in single narrow, then the blood pressure was measured after 30 minute. The end of day experiment (at day 20), posttest measurement of level protein in urine and uric acid plasma.The kidney of each rat was prepared to make histological specimen. The result showed increased of blood pressure and protenuria was found in group I. Buah merah oil may prevent increasing of protenuria at group II, III, and IV. There is significant difference of uric acid level (p<0,05) in group I compared to the other group. Group I has highest uric acid plasma level with mean value 9,93 mg/dl, but in group II, III, and IV is 6,16 mg/dl, 6,07 mg/dl, and 5,96 mg/dl. Buah merah oil may ameliorate glomerular endotheliosis. Group I depict of glomerulus hypercelluler, occlusion of arterial lumen, and no eritrosit. This means glomerulus bloodless on group I. But the other 3 groups show the image of fullfill capillary lumen by eritrosit and hypocelluler. Bivariate correlation test resulted positive correlation (p<0,01) between blood pressure to protenuria and uric acid plasma level. The conclusion suggest that treatment of buah merah oil on preeclamptic animal model may prevent the increased of blood pressure, proteinuria, hyperuricemia, but in the hand this oil ameliorate glomerular endotheliosis.

Kata Kunci : Preeklamsia,Minyak Buah Merah