Hubungan Antara Kadar Homosistein dengan Derajat Keparahan pada Pasien Stroke Iskemik Fase Akut di Rumah Sakit Umum Pusat Haji Adam Malik Medan

Abstract

Latar belakang. Peningkatan kadar homosistein merupakan faktor risiko independen untuk pasien stroke iskemik. Selain merupakan faktor risiko independen, homosistein juga sebagai faktor yang mempengaruhi prognosis stroke, namun hasilnya masih kontroversi. Tujuan. Mengetahui hubungan antara kadar homosistein dengan derajat keparahan pada pasien stroke iskemik fase akut. Metode. Penelitian analitik dengan desain cross sectional, melibatkan 45 pasien stroke iskemik fase akut yang dirawat inap di ruang stroke corner Rumah Sakit Umum Pusat Haji Adam Malik Medan. Kadar homosistein dikelompokkan atas 2 kategori, yaitu kadar homosistein tinggi (>15 μmol/l) normal (≤15 μmol/l). Derajat keparahan Stroke Iskemik Fase Akut diperiksa dengan menggunakan NIHSS. Hasil. Penderita stroke iskemik fase akut memiliki kadar homosistein minimum 4,4 μmol/l dan maksimum 24,1 μmol/l dengan rata-rata 11,5 μmol/l. Derajat keparahan stroke ringan, yaitu sebanyak 34 orang (75,6%) dan derajat keparahan stroke sedang, yaitu sebanyak 11 orang (24,4%). Hasil uji regresi logistik menunjukkan kadar homosistein berhubungan kuat degan derajat keparahan stroke iskemik fase akut. Artinya pasien stroke iskemik fase akut yang memiliki kadar homosistein tinggi diperkirakan dapat meningkatkan risiko keparahan stroke iskemik fase akut 6,960 kali dibandingkan dengan kadar homosistein normal (p=0,005; OR = 6,960; CI 95%; 1,523–31,811). Simpulan. Kadar homosistein menunjukkan hubungan yang kuat dengan derajat keparahan stroke iskemik fase akut.

Background. Elevated homocysteine levels are an independent risk factor for ischemic stroke patients. Besides being an independent risk factor, homocysteine is also a factor that affects the prognosis of stroke, but the results are still controversial. Objective. To Determine the relationship between homocysteine levels with the degree of severity in patients with acute phase ischemic stroke. Methods. An analytical study with cross sectional design, involving 45 acute phase ischemic stroke patients who were hospitalized in the stroke corner room at Haji Adam Malik General Hospital, Medan. Homocysteine levels are grouped into 2 categories, namely high homocysteine levels (> 15 μmol / l) normal (≤15 μmol / l). The severity of acute phase ischemic stroke was examined using National Institute of Health Stroke Scale (NIHSS). Results. Acute phase ischemic stroke patients have homocysteine levels of at least 4,4 μmol/l and maximum 24.1 μmol / l with average 11.5 μmol / l. 34 peoples (75,6%) suffers mild stroke and 11 people (24,4%) with moderate stroke. The logistic regression test results showed homocysteine levels were related to the severity of acute phase ischemic stroke. This means that acute phase ischemic stroke patients who have high homocysteine levels are estimated as predictors to increase the risk of acute phase ischemic stroke severity by 6,960 times compared to normal homocysteine levels (p = 0,005; OR = 6,960; 95% CI; 1,523-31,811). Conclusions Homocysteine levels show a strong relationship with the severity of acute phase ischemic stroke.