Sindrom metabolik sebagai prediktor outcome pasien stroke iskemik akut :: Laporan hasil penelitian

RUNTUWENE, Lily, dr. H. Pernodjo Dahlan, Sp.S(K)

2008 | Tesis | S2 PPDS I - Ilmu Penyakit Saraf

Latar Belakang: Sindrom metabolik merupakan kumpulan dari faktor risiko untuk terjadinya ateroskleoris. Sindrom metabolik bila ditemukan tiga atau lebih komponen hipertensi, obesitas sentral, hipertrigliserida, HDL kolesterol rendah dan gula darah puasa yang tinggi. Individu dengan sindrom metabolik mempunyai risiko tinggi terjadinya penyakit-penyakit kardiovaskuer dan berhubungan dengan peningkatan prevalensi stroke dan mempengaruhi outcome stroke. Penelitian tentang pengaruh sindrom metabolik terhadap outcome defisit neurologis sangat jarang. Tujuan: Untuk mengetahui pengaruh sindrom metabolik terhadap perburukan defisit neurologis pada stroke iskemik akut. Metode: Penelitian ini merupakan penelitian kohort prospektif yang melibatkan 100 pasien stroke iskemik akut yang rawat inap di bangsal saraf/unit stroke RSUP DR.Sardjito, Yogyakarta. Penelitian dilakukan sejak Januari-April 2008 Hasil: Terdapat 100 subyek penelitian, 50 pasien stroke iskemik akut dengan sindrom metabolik dan 50 pasien stroke iskemik akut tanpa sindrom metabolik. Analisis univariat didapatkan sindrom metabolik bermakna sebagai prediktor outcome defisit neurologis pada pasien stroke iskemik akut RR=2,56 (p= 0,003, CI 95% = 1,32– 4,96). Perburukan defisit neurologis berhubungan dengan peningkatan jumlah faktor risiko, RR 2 faktor risiko = 1,23 (p=0,5, CI 95% 0,35-4,33), RR 3 faktor risiko = 2,54 (p=0,006, CI 95% 1,27-5,08), RR 4 faktor risiko = 2,78 (p=0,03, CI 95% = 1,23- 6,30). Simpulan: Sindrom metabolik secara bermakna mempengaruhi perburukan defisit neurologis dibanding pasien yang tanpa sindrom metabolik. Peningkatan jumlah faktor risiko meningkatkan risiko relatif perburukan defisit neurologis.

Background: The metabolic syndrome (MetS) consists of a constellation of vascular risk factors promoting the development of atherosclerotic. The diagnosed of MetS are any three or more of the following criteria: high blood pressure, centrally distributed obesity, elevated triglycerides, decreased high-density lipoproteins and impaired fasting glucose. This cluster of highly interrelated factors appears to increase the individual’s risk of vascular disease such as cardiovascular disease and have assosiated with increased prevalance of stroke and influenced the stroke outcome. Study about the impact of MetS on outcome neurological deficits in acute stroke is rare. Purpose: To asses the influence of the metabolic syndrome on worsening neurological deficits in acute ischemic stroke. Method: This research used a prospective cohort study, involving 100 patients acute ischemic stroke in neurology ward/stroke unit DR.Sardjito Hospital, Yogyakarta from January until April 2008. Results: There were 100 subjects eligible with inclusion and exlucion criteria of this study, divided into two group, 50 patients with MetS and 50 patients without MetS. The univariate analysis showed that MetS significant was predictor outcome neurological deficits in acute ischemic stroke (RR=2,56, p=0,003. CI95%= 1,32- 4,96). Worsening of neurological deficits was associated with the increased of number risk factor (RR 2 risk factor = 1,23, p=0,05, CI95% 0,35-4,33; RR 3 risk factor = 2,54, p=0,006, CI 95% 1,27-5,08; RR 4 risk factor = 2,78, p=0,03, CI 95%= 1,23-6,30). Conclusion: The Metabolic syndrome is significant influenced worsening neurological deficits in acute ischemic stroke. Increased number of risk factor associated with the increased of relative risk worsening neurological deficits

Kata Kunci : Sindrom metabolik,Stroke iskemik,Outcome,Stroke,Kohort prospektif, Metabolic syndrome, ischemic stroke, outcome, prospective cohort