Peran Inhibitor Hmg-Coa Reduktase Dalam Penurunan Interleukin-6 Terhadap Hasil Akhir Klinis Penderita Kontusio Serebri

Abstract

Name: Sabri Study program: Magister of Clinical Medicine Title: The role of HMG-CoA reductase inhibitor in decreased of interleukin-6 to end result of clinical cerebral contusion Purpose: Evaluate treatment result of contusion cerebral patients with HMG-CoA reductase inhibitor with interleukin-6 serum as a parameter Place: Neurosurgery department FK USU-RS HAM, Clinical Pathology Department FK USU-RS HAM Subject: 50 patients of moderate head injury with head ct-scan show cerebral contusion Result: This research result GOS score when discharged for standard therapy is 4,08±1,00 and standard therapy with HMG-CoA reductase inhibitor is 4,13±1,09. This show a little elevation with standard therapy with HMG-CoA reductase inhibitor, statistic show not significant with p= 0,822. Barthel score when patient discharged for therapy standard is 78,18±15,85 and standard therapy with HMG-CoA reductase inhibitor is 82,38±11,79. There is a trend of Barthel score escalation on standard therapy with HMG-CoA reductase inhibitor but statistically not significant with p value= 0,429. MMSE score when discharged for therapy standard 15,27±12,07 and standard therapy with HMG-CoA reductase inhibitor 13,24±14,29, this show lower result result on the standard therapy with HMG-CoA reductase inhibitor, but still in the same category. Statistically, cognitive disturbance was not significant p= 0,808. One month GOS of standard therapy is 4,81 ±0,39 and standard therapy with HMG-CoA reductase inhibitor is 4,90±0,30, this show a little escalation on the grup that statistically not significant p value=0,418. One month Barthel index for therapy standard 95,00±7,56 and standard therapy with HMG-CoA reductase inhibitor 96,67±5,55, this show a little escalation on the standard therapy with HMG-CoA reductase inhibitor but not statistically not significant p=0,616. MMSE score after one month show on standard therapy: normal cognitive 18(81,8%), mild cognitive disturbance 3(13,6%) and severe cognitive disturbance 1 (4,5%). On standard therapy with HMG-CoA reductase inhibitor, normal cognitive is 17 (81%), mild cognitive disturbance 4(19%) and no severe cognitive disturbance, with p value p= 0,563 so there is no significant statistic difference. This research show interleukin-6 value on day one is 9,74±15,77 and day five is 20 ±1,98, while on standard therapy with HMG-CoA reductase inhibitor show interleukin-6 value on day one is 11,96±12,78 and day five is 1,25±3,33, with p=0,295for interleukin-6 day one and p=0,834 for interleukin-6 day . So there is no significant diffrence of interleukin-6 value on day one and five after HMG-CoA reductase inhibitor although there is a decline value trend after HMG-CoA reductase inhibitor treatment. Conclusion: There is no significant correlation between treatment HMG CoA reductase inhibitor with clinical result (GOS, Barthel index and MMSE). There is no significant correlation between interleukin-6 serum value with clinical result (GOS, Barthel index and MMSE) on day one dan five

Nama:Sabri Program studi : Magister Kedokteran Klinik Judul : Peran inhibitor HMG-CoA reduktase dalam penurunan interleukin-6 terhadap hasil akhir klinis penderita kontusio serebri Tujuan:Menilai hasil akhir klinis pengobatan penderita kontusio serebri dengan terapi inhibitor HMG-CoA reduktase dengan parameter interleukin-6 serum Tempat penelitian:Departemen Bedah Saraf FK USU-RS.HAM, Depatemen Patologi Klinik FK USU-RS.HAM Subjek penelitian:50 orang penderita cedera kepala sedang dengan gambaran CT scan kontusio serebri Hasil: Pada penelitian ini didapat nilai GOS saat pulang untuk terapi standar 4,08±1,00 dan terapi standar tambah inhibitor HMG-CoA reduktase 4,13±1,09, terlihat kenaikan nilai kelompok standar tambah inhibitor HMG-CoA reduktase sangat kecil, secara statistik tidak bermakna (p=0,822). Nilai Barthel saat pulang untuk terapi standar 78,18±15,85 dan terapi standar tambah inhibitor HMG-CoA reduktase 82,38±11,79, terlihat ada kecendrungan kenaikan nilai Barthel pada kelompok inhibitor HMG-CoA reduktase namun tidak signifikan (p=0,429). Nilai MMSE saat pulang untuk standar 15,27±12,07 dan standar tambah inhibitor HMG-CoA reduktase 13,24±14,29 , disini terlihat nilai lebih rendah pada kelompok standar tambah inhibitor HMG-CoA reduktase, namum masih dalam katagori yang sama gangguan kognitif , secara statistik tidak bermakna (p=0,808). Nilai GOS 1 bulan terapi standar 4,81 ±0,39 dan standar tambah inhibitor HMG-CoA reduktase 4,90±0,30, sedikit kecendrungan lebih tinggi pada inhibitor HMG-CoA reduktase namun secara tidak bermakna (p=0,418). Nilai Barthel’s 1 bulan untuk terapi standar dijumpai 95,00±7,56 dan terapi standar tambah inhibitor HMG-CoA reduktase 96,67±5,55, hanya sedikit meningkat pada kelompok inhibitor HMG-CoA reduktase namun tidak bermakna (p=0,616). Nilai MMSE pada 1bulan dijumpai untuk terapi standar; kognitif normal 18(81,80%), gangguan kognitif ringan 3(13,60%), gangguan kognitigf berat 1(4,5%) sedangkan pada terapi standar tambah inhibitor HMG-CoA reduktase; kognitif normal 17(81,00%), gangguan kognitif ringan 4(19,00%) dan tidak gangguan kognitif berat, tidak dijumpai perbedaan signifikans (p=0,563). Pada penelitian ini, nilai interleukin -6 hari pertama 9,74±15,77 dan hari kelima 3,20 ±1,98 sedangkan pada kelompok standar tambah inhibitor HMG CoA reduktase dijumpai nilai interleukin-6 hari pertama 11,96±12,78 dan hari kelima 1,25±3,33, dijumpai nilai p=0,295 untuk interleukin-6 hari pertama dan p=0,834 untuk interlaeukin-6 hari ke -5 ,dengan demikian tidak ada perbedaan signifikan kadar interleukin hari pertama dan hari kelima setelah terapi inhibitor HMG-CoA reduktase walaupun terlihat kecendrungan penurunan nilai setelah terapi inhibitor HMG-CoA reduktase Simpulan:,Tidak terdapat korelasi yang bermakna antara perlakuan inhibitor HMG-CoA reduktase dengan hasil akhir klinis (GOS, Barthel Indeks dan MMSE). Tidak terdapat korelasi yang bermakna antara kadar interleukin-6 serum dengan hasil akhir klinis (GOS,Barthel Indeks dan MMSE), pada hari pertama dan hari kelima.