Hubungan Antara Kadar Serum Neuron Spesific Enolase dengan Volume Lesi dan Luaran Fungsional pada Pasien Stroke Fase Akut

Abstract

Latar belakang Neuron specific enolase (NSE) dilepaskan pada cairan serebrospinal dan darah sebagai respon terhadap berbagai bentuk cedera otak. Kadar serum NSE dapat digunakan sebagai penanda sel saraf otak baik pada stroke iskemik dan stroke hemoragik otak yang dikaitkan dengan luasnya volume lesi dan luaran fungsional. Tujuan Untuk mengetahui hubungan antara kadar serum NSE dengan volume lesi dan luaran fungsional pada pasien stroke fase akut. Metode Studi potong lintang dengan 29 subjek stroke iskemik dan 29 subjek stroke hemoragik di RSUP H Adam Malik Medan. Semua pasien menjalani penilaian skor national institute of health stroke scale (NIHSS), skor modified rankin scale (mRS), dan penilaian volume lesi. Hasil Hasil Subjek terdiri dari laki-laki 27 orang (46,4%) dan perempuan 31 orang (53,4%) dengan rerata umur yaitu 61,67± 12,26 tahun. Rerata kadar serum NSE pada pasien stroke yaitu 19,79 ± 8,88 ng/ml dan volume lesi 25,09 ± 24,52 ml. Terdapat korelasi bermakna peningkatan kadar NSE serum dengan volume infark (r=0,863, p<0,001) dan volume perdarahan (r=0,644, p <0,001) serta luaran fungsional yang dinilai dengan skor NIHSS (r=0,761, p<0,001) dan mRS (r=0,762, p<0,001) pada stroke iskemik, serta skor NIHSS (r=0,525, p=0,003) dan mRS (r=0,468, p = 0,010) pada stroke hemoragik. Kesimpulan Terdapat hubungan yang bermakna antara peningkatan kadar NSE serum dengan volume lesi dan luaran fungsional.

Background Neuron spesific enolase (NSE) released in the cerebrospinal fluid and blood stream in response to brain damage. Serum NSE levels can be used as a marker of brain nerve cells either in ischemic or hemorrhagic stroke which associated with lesion volume and functional outcome. Objective The aim of this study was to evaluate the correlation between NSE serum level with lesion volume and functional outcome in acute stroke patients. Method A cross sectional study was conducted in 29 patients ischemic stroke and 29 hemmorrhagic stroke who admitted to Haji Adam general hospital. All the subjects were assessed with national institute of health stroke scale (NIHSS) score, modified rankin scale (mRS), and assessment of lesion volume. Results Subjects consists of 27 male (46.4%) and 31 female (53.4%), with mean age of 61.67 ± 12.26 years. The mean serum NSE levels in stroke patients were19.79 ± 8.88 ng/ml and lesion volume was 25,09 ± 24,52 ml. There was a significant positive correlation of increase in serum NSE levels with infarct volume (r=0.863, p<0.001) and hemorrhagic volume (r=0.644, p<0.001) and functional outcome assessed by NIHSS score (r=0.761, p<0.001) and mRS score (r=0.762, p<0.001) in ischemic stroke and NIHSS score (r=0.525, p=0.003) and mRS score (r=0.468, p=0.010) in hemorrhagic stroke. Conclusions There was a significant correlation between the increase in serum NSE levels and the volume of lesions and functional outcomes.