Hubungan antara skor child dengan kadar cystatin C pada penderita sirosis hati

MULYA, Deshinta Putri, Prof. dr. Siti Nurdjanah, Sp.PD-KGEH, M.Kes

2010 | Tesis | S2 Ilmu Kedokteran Klinik

Disfungsi ginjal merupakan masalah serius dan memberikan prognosis yang buruk bagi penderita sirosis hati tahap lanjut, dimana keadaan tersebut dapat berkembang menjadi keadaan gagal ginjal yang dikenal dengan istilah Sindroma Hepato Renal. Penggunaan Cytatin C sebagai penanda penurunan fungsi ginjal pada penderita sirosis hati telah banyak teruji. Data mengenai seberapa jauh keparahan sirosis hati dapat mempengaruhi penurunan fungsi ginjal belum banyak diketahui. Penelitian ini bertujuan mengetahui hubungan derajat keparahan hati (Skor Child Pugh) dengan kadar Cystatin C. Penelitian ini adalah suatu penelitian potong lintang. Populasi yang diteliti adalah penderita sirosis hati yang mengunjungi poliklinik Gastroentero-hepatologi dan dirawat di bangsal penyakit dalam RSUP Dr. Sardjito Yogyakarta selama bulan Oktober 2009 – Maret 2010. Data diolah dengan komputer, analisa hubungan skor Child dengan peningkatan kadar Cystatin C menggunakan Spearman Correlation karena data tidak terdistribusi normal. Didapakan sebanyak 48 subyek penelitian selama bulan Oktober 2009 – Maret 2010. Jumlah laki-laki adalah sebanyak 35 pasien (72,9%) dan jumlah pasien wanita sebanyak 13 pasien (27,1%) dengan usia rata-rata 53,1+ 11,9 tahun. Penderita dengan Child A sebanyak 9 pasien(18,8%), Child B 14 pasien (29,2%) dan yang terbanyak adalah penderita sirosis hati Child C yaitu 25 orang (52,1%). Penderita sirosis hati yang memiliki kadar Cystatin C< 0,96 mg/L sebanyak 22 orang (45,83%) dan 26 orang (54,1%) lainnya memiliki kadar Cystatin C > 0,96 mg/L. Skor Child memiliki hubungan positif sedang terhadap peningkatan kadar Cystatin C (p: 0,000; r: 0,566) dengan persamaan regresi linier Cystatin = 0,37 + 0,08*Skor Child (r Square 0,32). Penelitian ini menyimpulkan bahwa Skor Child memiliki hubungan positif sedang tehadap peningkatan kadar Cystatin C.

Renal dysfunction is a serious problem and provide a poor prognosis for patients with advanced liver cirrhosis, where this condition can progress to kidney failure condition known as Hepato Renal Syndrome. Cytatin C utilization as a marker of decreased kidney function in patients with liver cirrhosis has been widely proven. Data on how far the severity of liver cirrhosis can affect the decline in renal function has not been widely known. This study aimed is to verify correlation between the severity degree of the liver (Child score) with levels of Cystatin C serum. This study was a cross sectional study. Population studied were patients with liver cirrhosis who visited the clinic of Gastroentero-hepatology and treated in the department of Internal Medicine ward Dr. Sardjito Hospital- Yogyakarta during October 2009 - March 2010. Data were analyzed with a computer, We analyzed the Child score correlation with increased levels of Cystatin C using Spearman correlation for data not normally distributed. We found 48 research subjects during the month of October 2009 - March 2010. The number of men were 35 patients (72.9%) and the number of female patients were 13 patients (27,1%) with average age 53.1 + 11.9 years. Patients with Child A were nine patients (18.8%), Child B 14 patients (29.2%) and the majority were patients with Child C, 25 patients (52,1%). Liver cirrhosis patients who had Cystatin C levels <0.96 mg/L were 22 people (45.83%) and 26 patients (54.1%), had higher levels of Cystatin C> 0.96 mg/L. Child score was positively correlated to increased levels of Cystatin C (p: 0.000; r: 0.566) linear regression equation with Cystatin was = 0.37 + 0.08 * Child score (r square 0.32). This study concluded that the Child score had a moderate positive correlate with Cystatin C serum level.

Kata Kunci : Sirosis hati, Skor CHILD, Cystatin C, Liver Cirrhosis, Score CHILD, Cystatin C