Pengaruh pemberian minyak buah merah (Pandanus conoideus lam) terhadap kejadian preeklampsia studi asam urat dan endoteliosis pada glomerulus hewan model preeklampsia rattus norvegicus strain wistar

IRAWIRAMAN, Hadi, dr. Harijadi, Sp.PA(K)

2010 | Tesis | S2 Patologi Anatomi

Latar belakang : Stres oksidatif berperan dalam patogenesis preeklamsia. Stres oksidatif pada sirkulasi sistemik yang dipicu oleh gangguan perfusi pada lasenta merupakan penyebab terjadinya disfungsi endotel. Disfungsi endotel akan menimbulkan gejala klinik preeklamsia seperti proteinuria, hiperurisemia dan gambaran histopatologik endoteliosis glomerular pada ginjal. Pencegahan preeklamsia dengan pemberian antioksidan sejak awal kehamilan memberikan harapan sejak diketahui bahwa stres oksidatif berperan dalam patogenesis preeklamsia.Tujuan : Penelitian ini bertujuan untuk mengkaji pengaruh pemberian minyak buah merah yang banyak mengandung antioksidan α tokoferol dan β-karoten terhadap asam urat plasma dan gambaran histopatologik endoteliosis glomerular pada hewan model preeklamsia.Metode : Tikus putih strain Wistar,umur 9-12 minggu, 32 ekor hamil hari pertama dibagi menjadi 4 kelompok. Kelompok I,II, III dan IV,pada hari keenam kehamilan diukur tekanan darah dan proteinuria pretest, mulai hari ketujuh sampai hari kedua puluh 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 ketujuh sampai keempat belas kehamilan semua kelompok diberi stres bising, hari ketujuh sampai kedua puluh kehamilan diberi stres overpopulasi. Hari kedelapan belas kehamilan diberi stres akut dan pengukuran tekanan darah posttest, kemudian hari kedua puluh dilakukan pengukuran proteinuria posttest, asam urat dan pembuatan preparat histopatologik endoteliosis glomerular.Hasil : Kadar asam urat plasma tertinggi terdapat pada kelompok I dengan rata-rata 9.93 mg/dl,Kadar asam urat plasma pada kelompok II, III, dan IV dengan rata-rata 6.16 mg/dl, 6.07 mg/dl,dan 5.96 mg/dl. Terdapat perbedaan bermakna (p<0.05) kadar asam urat plasma antara kelompok I dengan kelompok II, III dan IV . Jumlah endotel glomerulus pada kelompok I ratarata 65,5, pada kelompok II ; 24,13, kelompok III ; 24,25 dan kelompok IV ; 23,56. Variasi dosis pada kelompok, II,III, dan IV tidak memperlihatkan perbedaan hasil yang bermakna.Pengujian korelasi bivariat mendapatkan adanya hubungan bermakna (P<0.01) antara kadar asam urat plasma dan jumlah endotel glomerulus Kesimpulan : Disimpulkan bahwa pemberian minyak buah merah dapat mencegah terjadinya Hiperurisemia dan memperbaiki gambaran endoteliosis glomerular pada hewan model preeklamsia.

Background. Oxidative stress has a central role in the pathogenesis of preeclampsia Oxidative stress in systemic circulation which is triggered by ypoperfusion of placenta may develop endothelial dysfunction. Endothelial dysfunction will generate preeclampsia symptoms namely proteinuria, hyperuricemia and glomerular endotheliosis as the histopathological feature in the kidney. Pre-eclampsia prevention with early pregnancy antioxidant administration seems to give a better expectation since the fact that oxidative stress plays a part in the pathogenesis of preeclampsia.Objective. The aim of this study is to identify the effect of buah merah oil containing a lot of antioxidants such as α-tocopherol and β-carotene on glomerular endotheliosis in the preeclampsia animal model.Methods. hirty two pregnant Wistar strain white rats were randomly divided into 4 groups on the first day of pregnancy. The measurement of blood pressure and proteinuria pretest were carried out on day 6 of pregnancy. Afterward, starting from day 7 until day 20 of pregnancy,group I received distilled water, group II, III, and IV were treated orally with buah merah oil 0.15 ml /day, 0.3 ml / day, and 0.6 ml / day. All of the groups were exposed to high level noise (100 dB) to generate stressful condition from day 7 until day 14 of pregnancy, and at the same time they were placed in an overpopulated cage from day 7 until day 20 of pregnancy. On day 18 of pregnancy, each mouse was exposed to acute stress by placing in a single narrow cage, and the blood pressure was measured after 30 minutes. Then on day 20 of pregnancy the proteinuria posttest and uric acid plasma level were measured, and the kidneys were processed to make histological specimens.Result: The highest uric acid plasma level was at group I with the mean 9.93 mg/dl, while rate of uric acid plasma level of groups II, III, and IV each 6.16 mg/dl, 6.07 mg/dl, and 5.96 mg/dl.There are significant differences (p<0.05) of uric acid plasma level between group I and group II,III, IV. The average number of glomerular endothelium in group I ;65.6, group II ;24.13, group III ;24.25 and group IV 23.56. Dosage variation administered in group II, III, and IV shows no significant difference. Examination with bivariate correlation showed that there is a positive relationship ( P<0.01) between glomerular endothelial number and uric acid plasma level Conclusion: The results suggest that the treatment of buah merah oil on preeclamptic animal model may prevent the increased hyperuricemia and remodeling of glomerular endotheliosis.

Kata Kunci : Preeklamsia,Minyak buah merah,Endoteliosis,Glomerular