Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Kadar Surfactant Protein-D Serum Pada Pasien Penyakit Paru Obstruktif Kronis Berkebahayaan Kambuhan Rendah Dan Tinggi (Serum Surfactant Protein-D Level in High and Low Risk of Exacerbation Chronic Obstructive Pulmonary Disease Patients)

Penyakit Paru Obstruktif Kronis (PPOK) menyebabkan angka kesakitan dan kematian ringgi di dunia. Kondisi kekambuhan di PPOK mempercepat penurunan fungsi paru dan status kesehatan, serta meningkatkan biaya pengobatan dan kebahayaan kematian penderita. Pemeriksaan spirometri masih memiliki kekurangan dalam menilai derajat berat dan kebahayaan kekambuhan pasien PPOK. Saat ini terdapat pemeriksaan tingkatsurfactant protein-D (SP-D serum) yaitu protein surfaktan yang dihasilkan oleh sd alveolar tipe 11 dan sel Clara yang memiliki peran mempertahankan stabilitas anatomi paru dan sistem imun di organ tubuh paru, bersifat khusus sebagai pertanda inflamasi dan kerusakan jaringan paru. Peningkatan tingkat serum SPD menandakan kebocoran epitel paru yang menunjukkan tingkat keparahan PPOK semakin meningkat, hal tersebut tercermin di tingkat kebahayaan kekambuhan yang dinilai berdasarkan combined COPD assessment menurut patokan GOLD tahun 2011. Penelitian ini bertujuan untuk mengetahul perbedaan tingkat serum SP-D antara pasien PPOK yang memiliki tingkat kebahayaan kekambuhan rendah dan yang tinggi. Penelitian dilakukan sejak bulan Maret hingga JuIm 2014 dengan subjek pasien PPOK berdasarkan pemeriksaan spirometri. Rentuk penelitian adalah perbandingan analitik dengan rancangan kajian potong lintang. Analisis statistik menggunakan uji nonparametrik Mann Whitney. Subjek penelirian berjumlah 62 orang. Tingkat serum SP-D pasien PPOI< kebahayaan kekambuhan rendah berbeda bermakna dengan yang tinggi, yaitu 1,8-68,4 ng/mL di pasien PPOK kebahayaan kekambuhan rendah dan 3,36-116,4 ng/mL di pasien PPOK kebahayaan kekambuhan tinggi (P=0,018). Simpulan di kajian ini ialah tingkat serum SP-D Iebih tinggi di pasien PPOK yang berkebahayaan kekambuhan tinggi dibandingkan dengan yang rendah, schingga tingkat serum SP-D cersebut dapat digunakan untuk menilai tingkat kondisi yang bersangkutan. Chronic obstructive pulmonary disease (COPD) cause high morbidity and mortality worldwide. The exacerbations in chronic obstructive pulmonary disease accelerate the decline in lung function and health status, as well as in increasing the treatment cost and mortality risk. The Spiro metric measurement has several limitations in assessing the severity as well as the exacerbation risk in COPD patients. Currently, has been available serum surfactant protein-D, a marker of lung inflammation and lung tissue damage. This protein is produced by the alveolar type II cells and the Clara cells that play role in maintaining the lung stability and pulmonary immune system. The increased level of serum SPD indicates that there is lung epitthelial leakage in line with COPD severity increment and reflected in COPD exacerbation level of risk according to combined COPD assessment GOLD criteria of the year 2011. The aim of this study was to know the differences of SAD serum levels between low and high risk of exacerbation in COPD patients by determination them. This study was conducted from March to July 2014. The subjects of this study were COPD patients diagnosed by spiro metric measurement. The research was conducted in comparative analytic way with a cross sectional study design. The statistical analysis was performed using Mann-Whitney non-parametric test. The subjects were 62 COPD patients. The SAD serum level at low risk of exacerbation group differ significantly compared to the high risk exacerbation group, 1.8-68.4 ng/mL and 3.36-116.4 ng/mL respectively (P=0.018). Based on this study it can be concluded that the SP-D serum levels were higher in COPD patients with high risk exacerbation than the lower risk one. The SAD serum levels maybe considered as a specific marker of lung tissue injury to assess the risk of the exacerbation in COPD patients.