Hubungan kadar partial presure ammonia dengan nilai number connection test A sebagai parameter ensefalopati hati pada pasien sirosis hati di RSUP DR. Sardjito

RITONGA, Patogu Iman Dimanoto, Prof. dr. Hj. Siti Nurdjanah, M.Kes., SpPD-KGEH

2008 | Tesis | S2 Ilmu Penyakit Dalam

Latar Belakang: Hubungan antara otak dan hati sudah lama diketahui. Ensefalopati hati merupakan penyebab utama kesakitan dan kematian pada pasien dengan penyakit hati menahun. Sekitar 30% pasien yang meninggal pada stadium lanjut penyakit hati mengalami ensefalopati hati yang bermakna, bahkan mendekati koma. Didapatkan hubungan antara kadar ammonia dengan derajad ensefalopati hati, walaupun data yang didapat belum sepenuhnya konsisten. Partial pressure ammonia dilaporkan mempunyai hubungan dengan derajad ensefalopati yang lebih baik dibandingkan kadar ammonia total. Partial pressure ammonia menggambarkan paparan amonia diotak pada pasien ensefalopati hati. Tes NCT A merupakan bagian dari tes psikometri. Tes ini paling sering digunakan dan mudah serta hasilnya bisa dikuantifikasi dengan mudah. Tujuan Penelitian: Penelitian ini bertujuan untuk mengetahui hubungan antara kadar partial pressure ammonia dengan ensefalopati hati yang dinilai dengan tes NCT A. Metoda Penelitian: Penelitian dilakukan secara potong lintang pada subyek penelitian penderita sirosis hati dengan ensefalopati hati yang dirawat di bangsal perawatan ilmu penyakit dalam. Penelitian dilakukan mulai bulan Januari 2008 sampai terpenuhinya subyek penelitian. Hasil Penelitian: Jumlah subyek penelitian adalah 24 orang yang memenuhi kriteria inklusi dan eksklusi penelitian dan setuju untuk mengikuti penelitian. Rerata usia subyek penelitian 51,4 ± 12,6 tahun dengan usia terendah 41 tahun dan usia tertinggi 58 tahun. Rerata kadar partial pressure ammonia 7,92 ± 3,09 dan rerata waktu untuk mengerjakan tes NCT A sebesar 100,17 ± 91,38 detik. Analisa statistik dengan uji korelasi Spearman didapatkan korelasi antara kadar partial pressure ammonia dengan waktu tes NCT A sebesar 0,1 (p=0,71) dan korelasi antara kadar pH dengan NCT A sebesar 0,3 (p=0,20). Kesimpulan: Didapatkan korelasi yang lemah antara partial pressure ammonia dengan nilai NCT A dengan koefisien korelasi (r) sebesar 0,1 pada penderita sirosis hati dengan ensefalopati di RSUP Dr. Sardjito.

Background: Relation between liver and brain has been long enough been known. Liver encephalopathy represented the root cause of mortality and morbidity at patients with chronic liver disease. About 30% patients dying at chronic stadium of liver disease have a liver encephalopathy having a meaning, even come or near comma. There is a relation between level of ammonia with severity of liver encephalopathy, although got data not yet fully consistence. Partial pressure ammonia reported to have relation with severity of liver encephalopathy which is better to be compared to level of total ammonia. Partial pressure ammonia depicted presentation of ammonia at the brain of liver encephalopathy patients. NCT A test represent the part of psychometry test. The test is the most often used and easy to and also its result can be kuantification easily. Target: This Research aim is to know relationship between level of partial ammonia pressure with assessed liver encephalopathy with NCT A test. Method: Research conducted with cross sectional method with subject research of patient of liver cirrhosis with taken care of liver encephalopathy which admitted at internal medicine ward. Research start at January 2008 until it fulfilled of research subject. Result: 24 research subject are fulfill inclusion and of exclusion criterion research and agree to follow research. Age average of subject research 51.4 ± 12.6 year with the lowest age is 41 highest age and year 58 year. Rate average of partial ammonia pressure 7.92 ± 3.09 and time average to do NCT A test equal to 100.17 ± 91.38 second. Statistical analysis with correlation test of Spearman got correlation between rate of partial ammonia pressure with time of test NCT A equal to 0,1 (p=0,71), between rate of pH with NCT A equal to 0,3 ( p=0,20). Conclusion: There is a weak correlation between partial pressure ammonia with value of NCT A with correlation coefficient ( r) equal to 0,1 at patient of liver cirrhosis with encephalopathy in RSUP Dr. Sardjito

Kata Kunci : Partial pressure ammonia,NCT A,Sirosis hati,Ensefalopati hati,partial pressure ammonia,NCT A,liver cirrhosis,liver encephalopathy