perbedaan kadar tumor necrosis factor alfa pada penderita hepatitis kronik dan sirosis hati

MARLAYANTI, dr.Neneng Ratnasari, Sp.PD, KGEH; dr.Sutanto Maduseno, Sp.PD, KGEH

2014 | Tesis | SP Ilmu Penyakit Dalam

Latar belakang : Sirosis merupakan penyebab kematian utama yang kesembilan di Amerika serikat, dan bertanggung jawab terhadap 1,2 persen seluruh kematian di Amerika serikat. Peningkatan kadar TNF alpha berkorelasi dengan inflamasi hati, nekrosis, dan gagal hati karena TNF alpha dibentuk sebagai respon terhadap injuri jaringan serta dihubungkan dengan peningkatan progresi siklus sel dan stress oksidatif. Pada hati, TNF alpha terlibat dalam patofisiologi hepatitis viral, penyakit hati alkoholik, nonalcoholic fatty liver disease, dan ischemia-reperfusion (I/R) injury. Tujuan penelitian : Penelitian ini bertujuan untuk mengetahui bahwa rerata kadar TNF alpha pada sirosis hati lebih tinggi daripada rerata kadar TNF alpha pada hepatitis kronik. Metode : Desain penelitian adalah studi potong lintang. Subyek penelitian ini adalah penderita hepatitis kronik dan sirosis hati yang berobat dipoliklinik atau menjalani rawat inap dibangsal penyakit dalam RSUP DR Sardjito yang memenuhi kriteria inklusi dan eksklusi. Hubungan antara kadar TNF alpha dengan hepatitis kronik dan sirosis hati dianalisis dengan menggunakan uji Mann whitney U. Analisa data dilakukan secara komputerisasi. Perbedaan dianggap bermakna jika didapatkan P<0,05 dengan interval kepercayaan 95%. Hasil : didapatkan 40 pasien yang terdiri dari 18 orang pasien hepatitis kronik dan 22 orang pasien dengan sirosis hati. Rerata kadar TNF alpha penderita hepatitis kronik 16,06+_2,60 pg/mL, sedangkan kadar TNF alpha penderita sirosis hati 28,01+_3,19 pg/mL, dan berbeda secara statistik. Kesimpulan : Rerata kadar TNF alpha pada penderita sirosis hati lebih tinggi daripada rerata kadar TNF alpha pada hepatitis kronik.

Background. Cirrhosis is the ninth leading cause of death in the United States and is responsible for 1,2 % of all deaths in the United States. Increased levels of TNF alpha correlated with liver inflammation, necrosis, and liver failure due to TNF alpha was formed in response to tissue injury and is associated with an increase in cell cycle progression and oxidative stress. At the liver pathofisiology, TNF alpha is involved in viral hepatitis, alcoholic liver disease, non alcoholic fatty liver disease, and ischemia reperfusion injury. Methods. The study design was cross sectional study. The subjects of this study were patients with chronic hepatitis and hepatic cirrhosis were treated in the clinic or hospitalized in the Internal Medicine ward Sardjito Hospital who met the inclusion and exclusion criteria. The relationship between levels of TNF alpha with chronic viral hepatitis and hepatic cirrhosis were analyzed using the mann whitney u test. Analysis of the data is computerized. Differences were considered significant if the obtained p<0,05 with 95% confidence intervals. Results : Obtained 40 patients consisted of 18 patients with chronic hepatitis and 22 with hepatic cirrhosis. The mean levels of TNF alpha patients with chronic hepatitis 16,06+_2,60 pg/mL,whereas levels of TNF alpha patients hepatic cirrhosis 28,01+_3,19 pg/ml,and statistically significant difference. Conclusion. The mean levels of TNF alpha in patients with hepatic cirrhosis is higher than mean levels of TNF alpha in chronic hepatitis.

Kata Kunci : tnf alfa, sirosis hati, hepatitis B kronik, hepatitis C kronik