HUBUNGAN ANTARA KADAR INTERLEUKIN 6 DENGANSKOR CHILD-PUGH PADA PENDERITA SIROSIS HATI

Risdianty Saragih, dr. Neneng Ratnasari, SpPD-KGEH

2014 | Tesis | S2 Ked.Klinik/MS-PPDS

Penyakit hati menahun dan sirosis merupakan penyebab kematian kesembilan di Amerika Serikat dan bertanggung jawab terhadap 1,2% seluruh kematian di Amerika Serikat. Morbiditas dan mortalitas sirosis tinggi akibat komplikasinya. Menilai prognosis pasien sirosis hati dengan modifikasi skor Child Pugh, didasarkan pada tingkat keparahan penyakit menurut tanda, gejala serta hasil pemeriksaan laboratorium, variabelnya meliputi kadar bilirubin, albumin, INR, pemanjangan parsial protrombine Time (PPT), ada tidaknya asites dan ensefalopati. Klasifikasi ini terdiri dari Child A, B, dan C. Sitokin merupakan kompleks molekul yang berperan dalam proses fisiologis dan patologis yang terjadi di hati. Kadar interleukin 6 meningkat pada pasien hepatitis terutama pada pasien sirosis hati dan karsinoma hepatoseluler (KHS). Kadar interleukin 6 dapat digunakan sebagai penanda progresifitas penyakit hati daripada menggunakan metode yang invasif. Tujuan penelitian ini adalah untuk menilai hubungan antara kadar interleukin 6 dengan severitas sirosis hati dengan menghubungkannya dengan modifikasi skor Child Pugh. Desain penelitian adalah metode potong lintang. Pengambilan sampel secara consecutive sampling. Subjek penelitian adalah pasien sirosis hati yang dirawat di poliklinik dan rawat inap RSUP dr. Sardjito Yogyakarta sejak November 2011 sampai November 2012. Hubungan antara kadar interleukin 6 dengan modifikasi skor Child Pugh menggunakan uji korelasi Spearman karena data tidak terdistribusi normal. Hubungan dianggap bermakna bila P < 0,05. Hasil penelitian didapatkan peningkatan kadar IL-6 seiring dengan peningkatan modifikasi skor Child-Pugh tetapi peningkatan ini tidak bermakna secara statistik (r = 0,09, p = 0,57). Kesimpulan : Terdapat peningkatan kadar IL-6 seiring dengan peningkatan modifikasi skor Child-Pugh tetapi memiliki korelasi yang lemah dan tidak bermakna secara statistik.

Chronic liver disease and cirrhosis is the ninth leading cause of death in the United States and responsible for 1.2% of all deaths in the United States. High morbidity and mortality due to complications of cirrhosis. Assessing the prognosis of patients with liver cirrhosis is used Child Pugh score modification which based on the severity of the disease according to the signs, symptoms and laboratory test results, the variables include the levels of bilirubin, albumin, INR, elongation parsial protrombine Time (PPT), presence or absence of ascites and encephalopathy. This classification consists of Child A, B, and C. Cytokines are molecules that play a role in the complex physiological and pathological processes that occur in the liver. Interleukin 6 levels are elevated in patients with hepatitis, especially in patients with liver cirrhosis and hepatocellular carcinoma (KHS). Interleukin 6 levels can be used as a marker of liver disease progression than using invasive methods. The aim of this study was to assess correlation between interleukin-6 levels with severity of liver cirrhosis by using with Child Pugh score modification. The study design was cross-sectional method. Subject of this study collected with consecutive sampling. Subjects of this study were liver cirrhosis patients who were treated in the inpatient clinic and patient in ward in internal department of dr. RSUP dr. Sardjito since November 2011 until November 2012. The relationship between levels of interleukin 6 with Child Pugh scores modification using Spearman correlation test. The relationship is considered significant when P <0.05. The results showed increased levels of IL-6 with increasing Child-Pugh score modification, but this increase was not statistically significant (r = 0.09, p = 0.57). Conclussion: This study showed that raising of IL-6 levels is followed with increasing of Child-Pugh Score modification but this correlation is weak and not statistically significant

Kata Kunci : sirosis hati, interleukin 6, modifikasi skor Child Pugh