ABSTRAK
Stroke iskemik akut memicu respon inflamasi menyebabkan peningkatan kadar C-reaktif protein. Peran CRP sebagai marker selama dan setelah stroke iskemik kurang dipelajari secara ekstensif dibanding dengan penyakit arteri koroner. Penelitian ini bertujuan mengetahui hubungan kadar serum high sensitivity C-reaktif protein dengan tingkat keparahan stroke iskemik fase akut sehingga dengan demikian dapat memberikan petunjuk untuk pengembangan terapi yang lebih efektif. Desain penelitian ini merupakan penelitian potong lintang yang dilakukan bulan April – Juni 2015. Teknik sampling dengan purposive sampling, pasien first stroke, onset ≤ 72 jam, di bangsal saraf RSDM. Pengukuran HS-CRP dilakukan di laboratorium RSDM. Tingkat keparahan stroke dinilai dengan NIHSS. Analisis variabel bivariat menggunakan uji korelasi spearman dan pearson untuk variabel berskala numerik dan uji korelasi lambda untuk variabel berskala nominal dan analisis multivariat regresi linier untuk nilai p < 0,05. Didapatkan 56 subjek, 60,71% laki-laki dan 39,29% perempuan, mean umur subjek 59,86 ± 1,18 tahun, mean onset masuk rumah sakit 17,21 ± 2,65 jam, mean pengambilan HS-CRP sejak onset 34 ± 2,62 jam dan mean HS-CRP 1,51 ± 0,34 mg/L. Hasil analisis korelasi bivariat menunjukkan hubungan yang signifikan, kadar serum HS-CRP (r = 0,300, p = 0,024) dan jenis stroke berdasarkan klasifikasi Bamford (r = 0,083, p = 0,038) dengan tingkat keparahan stroke iskemik fase akut. Hasil analisis multivariat regresi linier menunjukkan, hubungan signifikan kadar serum HS-CRP (p = <0,01) dengan tingkat keparahan stroke iskemik fase akut. Simpulan : Dari penelitian ini dapat disimpulkan bahwa didapatkan hubungan positif kadar serum HS-CRP, di sisi lain jenis stroke (Klasifikasi Bamford) juga berhubungan dengan tingkat keparahan stroke iskemik fase akut. Kata kunci : Stroke iskemik akut - hs-crp - tingkat keparahan stroke - NIHSS
ABSTRACT
Acute ischemic stroke triggers an inflammatory response causing increased levels of C-reactive protein. The role of CRP as a marker during and after an ischemic stroke is less studied extensively compared with coronary artery diseases. This study aims to determine the relationship of serum levels of high sensitivity C-reactive protein with severity of acute phase of ischemic stroke and thus can provide clues for more effective therapies. The study design was a cross sectional, conducted in April-June 2015 with purposive sampling technique, first stroke patient, the onset ≤ 72 hours, inward in RSDM. HS-CRP measurements performed at the laboratory of RSDM. The severity of stroke was assessed by NIHSS. Variables bivariate analysis using Spearman and Pearson correlation test for numerical variables and lambda correlation test for nominal variables and multivariate linear regression analysis for the value of p <0.05. Obtained 56 subjects, 60.71% were male and 39.29% female, the mean of age 59.86 ± 1.18 years, the mean onset of hospitalized 17.21 ± 2.65 hours, the mean of taking HS-CRP from the onset 34 ± 2.62 hours and the mean of HS-CRP 1.51 ± 0.34 mg / L. The results of bivariate correlation analysis showed significant association HS-CRP levels (r = 0,300, p = 0.024) and the type of stroke based on Bamford classification (r = 0,083, p = 0.038) with the severity of the acute phase of ischemic stroke. The results of multivariate linear regression analysis showed significant association HS-CRP levels (p = <0.01) with the severity of the acute phase of ischemic stroke. Conclusion: From this study it can be concluded that there are significant positive correlation of HS-CRP level, on the other hand type of stroke based on Bamford classification also correlated with the severity of acute phase of ischemic stroke. Keywords: acute ischemic stroke - hs-CRP - severity of the stroke - NIHSS