Hubungan antara kadar Matrix Metalloproteinase-3 (MMP-3) cairan Sinovia dengan Gradasi Radiografik pada Osteoartritis Lutut

SAAD, Luthfi, dr. Nyoman Kertia, SpPD-KR

2007 | Tesis | PPDS I Ilmu Penyakit Dalam

Latar belakang. Matriks metalloproteinase-3 merupakan salah satu dari sekumpulan enzim proteolitik yang dapat mendegradasi komponen matriks ekstraseluler dan diyakini mempunyai peranan penting pada destruksi sendi pada osteoartritis. Peningkatan kadar MMP-3 menunjukkan aktivitas destruksi kartilago pada osteoartritis. Pemeriksaan radiologis konvensional masih menjadi standar baku untuk evaluasi kerusakan kartilago artikuler, meskipun mempunyai beberapa keterbatasan. Tujuan penelitian. Mengetahui hubungan antara kadar matriks metalloproteinase-3 (MMP-3) cairan sinovia dengan gradasi radiografik pada osteoartritis lutut. Metode dan cara penelitian. Penelitian ini dilakukan secara potong lintang pada pasien osteoartritis lutut yang mengunjungi Poliklinik Reumatologi RSUP Dr. Sardjito pada bulan September sampai Desember 2006. Kadar MMP-3 cairan sinovia diperiksa dengan instant ELISA. Gradasi radiografik dinilai menurut kriteria Kellgren-Lawrence. Hubungan antara kadar MMP-3 cairan sinovia dengan gradasi radiografik dianalisa dengan uji-Mann Whitney U dan dihitung rasio prevalensi. Hasil penelitian. Didapatkan 21 subyek pene litian yang dianalisa dengan hasil jumlah subyek yang mempunyai kadar MMP-3 cairan sinovia = 250 ng/ml dengan kelompok gradasi radiografik 3-4 sebesar 6 orang, sedangkan jumlah subyek dengan kadar MMP-3 cairan sinovia < 250 ng/ml dengan kelompok gradasi radiografik 3-4 sebesar 3 orang. Subyek yang mempunyai kadar MMP-3 cairan sinovia = 250 ng/ml berjumlah 15 orang, sedangkan yang < 250 ng/ml berjumlah 6 orang. Setelah dilakukan analisa tidak didapatkan hubungan yang bermakna antara kadar MMP-3 cairan sinovia dengan gradasi radiografik (p = 1,000), dengan rasio prevalensi 0,889 (IK 95%: 0,505-1,565). Simpulan. Berdasarkan hasil penelitian ini tidak terdapat hubungan antara kadar MMP-3 cairan sinovia dengan gradasi radiografik OA lutut.

Background. Matrix metalloproteinase-3 is one of proteolytic enzyme able to degrade extracellular matrix component, which plays an important role in the articular destruction in OA. An increase in MMP-3 level indicated the activity of cartilage destruction in OA. A conventional radiologic examination has been a gold standart for the evaluation of articular cartilage despite of its limitations. Aim of study. To study the relationship between level of synovial MMP-3 with radiographic gradation in knee OA. Methods . This is a cross-sectional study in patient with osteoarthritis of the knee recruited from Rheumatology Department, Sardjito General Hospital Yogyakarta from September to December 2006. The synovial level of MMP-3 and the radiographic gradation were measured by ELISA and Kellgren-Lawrence criteria. The relationship between synovial MMP-3 level and radiographic gradation was analyzed by Mann- Whitney U test and a prevalence ratio was determined. Results. There was 21 subjects analyzed in this study. The number of subjects with synovial MMP-3 level = 250 ng/ml with radiographic gradation of 3-4 was 6 subjects. The number of subjects with synovial MMP-3 level < 250 ng/ml with radiographic gradation of 3-4 was 3 subjects. The number of subjects with synovial MMP-3 level = 250 ng/ml and < 250 ng/ml was 15 and 6 subjects, respectively. There was no significant relationship between synovial MMP-3 level with radiographic gradation (p = 1,000), with prevalence ratio 0,889 (95% CI: 0,505-1,565). Conclusion. There was no relationship between level of synovial MMP-3 with radiographic gradation of knee OA.

Kata Kunci : Osteoartritis Lutut,Kadar MMP 3,Gradasi Radiografik,Matrix metalloproteinase-3-radiographic gradation-knee osteoarthritis