Hubungan Antara Prothrombin Time, Activated Partial Thromboplastin Time dan D – Dimer dengan Prognosis Stroke Iskemik Akut di RSUP. H. Adam Malik Medan

Abstract

Background: The state of hypercoagulation is the basis for thrombosis and is significant for the occurrence of ischemic stroke. About 80% of ischemic strokes, the basis of which is atherothrombosis in large blood vessels, microateromes in small blood vessels, and emboli from the heart. Objective: To determine the relationship between prothrombin time, activated partial thromboplastin time and d-dimer with the prognosis of acute ischemic stroke. Method: This study uses a cross sectional design. Sampling was carried out at H. Adam Malik General Hospital Medan. The study sample was taken as many as 40 subjects consecutively. To find out the difference in prothrombin time, activated partial thromboplastin time and d-dimer levels and NIHSS scores paired t tests were used if the data were normally distributed and the Wilcoxon test if the data were not normally distributed. And to find out the relationship between prothrombin time, activated partial thromboplastin time and d-dimer with NIHSS scores on the first and seventh days the Spearman correlation was used. Results: Demographic characteristics of the subjects are the average age of 52-<68 years, the level of high school education, the work of housewives and farmers and the Batak tribe. There is no significant relationship between PT firts day and NIHSS score first day and there is no significant relationship between PT seventh day and NIHSS score seventh day. There is no significant relationship between APTT first day and NIHSS first day score and there is no significant relationship between APTT seventh day and NIHSS score seventh day. There is a significant relationship between D-dimer first day and NIHSS first day score and there is a significant relationship between D-dimer seventh day and NIHSS score seventh day. Conclusion: There is a significant relationship between d-dimer with NIHSS scores on the first and seventh days in patients with acute ischemic stroke.

Latar belakang: Keadaan hiperkoagulasi menjadi dasar timbulnya trombosis dan signifikan terhadap timbulnya stroke iskemik. Sekitar 80% kejadian stroke iskemik, dasar terjadinya adalah aterotrombosis pada pembuluh darah besar, mikroaterom pada pembuluh darah kecil, dan emboli dari jantung. Tujuan: Untuk mengetahui hubungan antara prothrombin time, activated partial thromboplastin time dan d – dimer dengan prognosis stroke iskemik akut Metode Penelitian: Penelitian ini menggunakan desain cross sectional. Pengambilan sampel dilakukan di RSUP H. Adam Malik Medan. Sampel penelitian diambil sebanyak 40 subjek secara konsekutif. Untuk mengetahui perbedaan kadar prothrombin time, activated partial thromboplastin time dan d – dimer dan skor NIHSS digunakan uji t berpasangan jika data berdistribusi normal dan uji Wilcoxon jika data tidak berdistribusi normal. Dan untuk mengetahui hubungan antara prothrombin time, activated partial thromboplastin time dan d – dimer dengan skor NIHSS pada hari pertama dan ke tujuh digunakan korelasi spearman. Hasil Penelitian: Karakteristik demografi subjek penelitian adalah usia rata-rata 52-<68 tahun, tingkat pendidikan SMA, pekerjaan ibu rumah tangga dan petani dan suku batak. Tidak terdapat hubungan yang signifikan antara PT H1 dengan skor NIHSS H1 dan tidak terdapat hubungan yang signifikan antara PT H7 dengan skor NIHSS H7. Tidak terdapat hubungan yang signifikan antara APTT H1 dengan skor NIHSS H1 dan tidak terdapat hubungan yang signifikan antara APTT H7 dengan skor NIHSS H7. Terdapat hubungan yang signifikan antara D - dimer H1 dengan skor NIHSS H1 dan terdapat hubungan yang signifikan antara D - dimer H7 dengan skor NIHSS H7. Kesimpulan: Terdapat hubungan yang signifikan antara d – dimer dengan skor NIHSS pada hari pertama dan ke tujuh pada pasien stroke iskemik akut.