Pustaka Ilmiah Universitas Padjadjaran

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Matriks Metaloproteinase-2 Dan Metaloproteinase-9 Pada Berbagai Spektrum Klinis Infeksi Virus Dengue Anak Serta Hubungannya Dengan Hematokrit Fase Akut

Pada infeksi virus dengue produksi matriks metaloproteinase-2 (MMP-2) dan MMP-9 yang berlebihan pada binatang percobaan menyebabkan kebocoran plasma melalui degradasi endotel vaskular. Untuk menentukan apakah MMP-2 dan MMP-9 serum fase akut dan konvalesens berhubungan dengan berbagai spektrum klinis infeksi virus dengue, serta dengan hematokrit fase akut, diperiksa MMP-2, MMP-9 serum, dan hematokrit terhadap 80 subjek penelitian dilakukan yang terdiri atas kelompok DD 26 anak, DBD 29 anak, dan SSD 25 anak. Selain itu dicatat infeksi primer dan sekunder sebagai faktor perancu. Penelitian ini merupakan observasional analitik rancangan studi potong lintang dengan pengamatan berulang, yang dilakukan di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung, periode Februari 2010–Desember 2012. Hubungan MMP-2 dan MMP-9 serum dengan spektrum klinis infeksi virus dengue dianalisis dengan Mancova repeated measure, sedangkan hubungan kadar MMP-2 dan MMP-9 serum dengan hematokrit fase akut menggunakan regresi linier. Hasil penelitian menunjukkan kadar MMP-2 serum fase akut lebih rendah dibandingkan dengan fase konvalesens pada semua spektrum klinis infeksi virus dengue, berturut-turut DD (681,06; 697,90 ng/mL), DBD (642,431; 736,32 ng/mL), SSD (506,02; 719,57 ng/mL) (p<0,005). Kadar MMP-9 serum fase akut lebih rendah dibandingkan dengan fase konvalesens pada semua spektrum klinis infeksi virus dengue, berturut-turut DD (95,09; 253 ng/mL), DBD (125,33; 277,70 ng/mL), SSD (160,40; 362,50 ng/mL) (p<0,001). Peningkatan kadar MMP-2 dan MMP-9 serum fase akut diikuti dengan penurunan hematokrit fase akut, masing-masing p=0,032 dan p=0,024. Simpulan, MMP-2 dan MMP-9 serum berhubungan bermakna dengan spektrum klinis infeksi virus dengue. Kadar MMP-2 dan MMP-9 serum fase akut berhubungan bermakna dengan hematokrit fase akut.

In dengue viral infection the overproduction of matrix metaloproteinase-2 (MMP-2) and MMP-9 result plasma leakage through degradation of vascular endothelial. To determine whether acute and convalescent phases of MMP-2 and MMP-9 serum are associated with various clinical spectrum of viral dengue infection, and with acute phase hematocrite. The MMP-2, MMP-9, and hematocrite were measured on 80 subjects consisted of 26 with DF, 29 with DHF, and 25 with DSS. Besides the primary and secondary infection were recorded as confounding factor. This was an analytical observational study with a cross sectional design and repetitive measure admitted to Hasan Sadikin General Hospital from February 2010 to December 2012. The association between MMP- 2 and MMP-9 serum with clinical spectrum of dengue viral infection was analyzed using Mancova repeated measure, while the association of MMP-2 and MMP-9 serum with acute phase hemaotcrite was analyzed using linear regression. The result showed that MMP-2 serum in acute phase was lower than convalescent phase in all clinical spectrum of dengue viral infection, respectively DF (681.06; 697.90 ng/mL), DHF (642.431; 736.32 ng/mL), DSS (506.02; 719.57 ng/mL) (p<0.005). The MMP-9 serum in acute phase was lower than convalescent phase in all clinical spectrum of dengue viral infection, respectively DF (95.09; 253 ng/mL), DHF (125.33; 277.70 ng/mL), DSS (160.40; 362.50 ng/mL) (p<0.001). The increase of MMP-2 and MMP-9 serum in acute phase were followed by the decrease of acute phase hematocrite, respectively p=0.032 and p=0.024. The conclusion of this study shows that MMP-2 and MMP-9 serum are significantly associated with clinical spectrum of dengue viral infection. The MMP-2 and MMP-9 serum in acute phase are associated with acute phase hematocrite.

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