Pengaruh Kenaikan Kadar Kortisol dan Adrenalin darah Terhadap Penurunan Sel T CD8 Pada cedera Otak Berat

Oleh :
Widjono - - Fak. Kedokteran

INTRODUCTION : Infection is o ne of the extra cranial complications o n severe head injury. It increased the morbidity and mortality and usually occurduring the second week patient’s hospital stay. The purpose of this study is to reveal a mechanism of decreasing immune response o n the severe head injury patients, focusing o n decrease T cell CD 8+, that influenced by increasing periferal blood kortisol and adrenalin level. MATERIAL AND METHOD: it is an analyctical observation study, by design : longitudinal prospective study, Blood sample of severe head injury group were taken at day three and day five during admission, and control group at day o ne and the alternate day. Severe head injury group is ten severe head injuries patients, that hospitalized from June to November 2005, at the Departement of Neurosurgery Medical Faculty, Airlangga University/ Dr. Soetomo Hospital, while ten control group was taken from healthy volunteer. A biological characteristic : age and sex have been machted, and a normal distribution test was perform. The obtained data were statistically analyzed. RESULT : Cortisol peripheral blood level’s severe head injury group were significantly increase than control group (at day three bloods examination p : 0,001 : day five examination p : 0,001). Adrenalin peripheral blood level were also significantly increase o n severe head injury group than control group. ( p : 0,049 o n day three blood examination, and p : 0,008 o n day five blood examination ). Interlukin-2, an entervening variable, at day three blood examination was slight higher an severe head injury group than control group, but o n day five blood examination this condition is reverse. At a day five blood examination, mean cases group’s IL-2 level is 4,82 + 2,00 pg/ml, while control group is 4,51 + 1,99 pg/ml. By regression analysis reveal that cortisol influence o n decreasing IL-2 ( p: 0,036 and T cell CD 8+, ( p: 0,011 ), while adrenalin is not. Conclusion : 2. Increased cortisol and adrenalin peripheral blood level o n severe head injury patient. Decreased IL-2 level and T cell CD 8+ count peripheral blood circulation. 3. Increasing cortisol blood level cause decreased IL-2 blood level .