EFEK ANTIINFLAMASI DOKSISIKLIN TERHADAP VOLUME EKSPIRASI PAKSA DETIK PERTAMA, MATRIKS METALLOPROTEINASE-9 SERUM, DAN HIGH SENSITIF C-REAKTIF PROTEIN SERUM PADA PENATALAKSANAAN PENYAKIT PARU OBSTRUKTIF KRONIK STABIL

Abstract

Ronike Yunus, 2013.. Tesis. Efek Antiinflamasi Doksisiklin Terhadap Volume Ekspirasi Paksa Detik Pertama, Matriks Metalloproteinase-9 serum, dan High Sensitif C-Reaktif Protein Serum Pada Penyakit Paru Obstruktif Kronik Stabil. Supervisor I: Prof. Dr. Suradi, dr., Sp.P(K),MARS, II: Prof. Dr. Muchsin D., dr., MARS, PFarK, AIFO. Program Studi Magister Kedokteran Keluarga, Program Pascasarjana Universitas Sebelas Maret Surakarta. RINGKASAN Inflamasi saluran napas pasien PPOK merupakan akibat respons inflamasi yang disebabkan iritasi kronik terutama asap rokok. Kelainan struktur jaringan berkaitan erat dengan respons inflamasi yang terjadi. Gangguan keseimbangan molekul proteolisis dan anti-proteolisis menghasilkan peningkatan aktivitas proteolisis, destruksi parenkim paru yang mengarah pada emfisema. Peningkatan aktivitas proteolisis mungkin merupakan konsekuensi inflamasi yaitu dengan pelepasan enzim proteolisis oleh sel inflamasi seperti makrofag dan netrofil, atau disebabkan faktor genetik seperti defisiensi α-1 antitripsin.Tujuan penelitian ini adalah untuk menganalisis efek antiinflamasi lokal dan sistemik doksisiklin dengan VEP1, konsentrasi MMP-9 serum, dan konsentrasi Hs-CRP serum pada penderita PPOK stabil Penelitian ini merupakan uji klinis quasi exsperimental, pre dan post design,. Jumlah sampel penelitian adalah 32 penderita PPOK stabil di Poliklinik rawat jalan RSUD Dr. Moewardi Surakarta pada bulan Desember-Februari 2012 yang diambil secara consecutive sampling. Variabel bebas adalah doksisiklin oral 100 mg, variabel tergantung adalah PPOK stabil. Data VEP1 diperoleh dari hasil pemeriksaan spirometri. MMP-9 serum diperoleh dari hasil pemeriksaan serum dengan menggunakan metode pengukuran tehnik kuantitatif sandwich enzyme immunoassay dan Hs-CRP serum diperoleh dari hasil pemeriksaan serum dengan menggunakan metode pengukuran immunoassay aglutinasi latex dengan antibodi monoklonal. Analisis yang digunakan adalah uji beda dengan uji parameter t test. Hubungan antara dua variabel numerik apabila data berdistribusi normal dilakukan uji korelasi Pearson dan dilakukan uji korelasi Spearman pada distribusi data tidak normal. Hasil penghitungan dinyatakan dalam koefisien korelasi Pearson (r). . Hasil penelitian didapatkan rerata umur 66,94 ± 8,75 tahun, keseluruhan lakilaki. Rerata indeks massa tubuh 31,16 kg/m2. Terdapat perbedaan nilai VEP1, konsentrasi serum MMP-9 sebelum dan sesudah pemberian doksisiklin. Tidak terdapat perbedaan konsentrasi Hs-CRP serum sebelum dan sesudah pemberian\ud doksisiklin. Tidak terdapat korelasi antara nilai VEP1, MMP-9 serum, dan Hs- CRP serum setelah pemberian doksisiklin. Kata kunci: VEP1, MMP-9, Hs-CRP, PPOK. Ronike Yunus. S500109031, 2013 Efek Antiinflamasi Doksisiklin Terhadap Volume Ekspirasi Paksa Detik Pertama, Matriks Metalloproteinase-9 serum, dan High Sensitif C-Reaktif Protein serum Pada Penyakit Paru Obstruktif Kronik Stabil. Thesis. Supervisor I: Prof. Dr. Suradi, dr., Sp.P(K),MARS, II: Prof. Dr. Muchsin D., dr., MARS, PFarK, AIFO.. Master Program in Family Medicine, Post-Graduate Program, Sebelas Maret University Surakarta. Abstract Respiratory inflammation in COPD is a result of inflammatory response that caused by chronic iritation especially from cigarette smoking. Abnormalities of tissues are closely related to the inflammatory response that induced by the exposure of noxious particles or gases in which cigarette smoke is the first and the most dominant risk factor among others. Imbalance between proteolytic and antiproteolytic molecules in COPD has initiated an increased in proteolytic activity leading to parenchymal lung destruction and thus the development of emphysema. This increase in proteolytic activity may be a consequence of inflammation due to the release of proteolytic enzime by inflammatory cells such as macropaghes and neutrophils, or genetic factors such as Alpha 1-antitrypsin deficiency. The purpose of this study was to investigate local and systemic inflammatory effects of doxcyciclin administration on FEV1 values, MMP-9 serum consentration, and Hs-CRP serum consentration in stable COPDs. This study was a clinical quasi experiment, pre and post design. Total sample was 32 patients with stable COPD taken consecutively at outpatient department of RSUD Dr. Moewardi Surakarta during December to February 2012. Independent variable of this study was doxcyciclin oral 100 mg, whilst the dependent variable was stable COPD. Data FEV1 were obtained by spirometry tests. MMP-9 serum was obtained from serum tests by using a sandwich enzyme immuno quantitative assay. Hs-CRP serum was obtained from serum tests by using an immuno aglutinasi latex assay with monoclonal antibodi. Data analysis used was a differential test with t-test parameter. The association between two numerical variables was measured by Pearsons coefficient of correlation, when the variables are bivariate normal, and by Spearman coefficient of correlation for non-normal data.The results were then defined as Pearsons coefficient of correlation (r). Results obtained were the average age of 66.94 + 8.75 years old, all male. The average of body mass index was 31.16 kg/m2. The result showed that there was differences in FEV1 values and MMP-9 serum concentration before and after doxcyciclin administration. On the other hand, there was no difference in Hs-CRP serum concentration before and after doxcyciclin administration. To conclude, there was no correlation between FEV1 values, MMP-9 serum concentration, and Hs-CRP serum concentration after the administration of doxcyciclin. Keywords : FEV1, MMP-9, Hs-CRP, COPD