Tesis

Perbedaan Kadar Interleukin-6 dan Protein C Reaktif pada Pen- rita Infeksi Dengue Dewasa Dengan dan Tanpa Kebocoran Plasma = The Differences of interleukin-6 and C-reactive protein level in adult dengue infection patients with and without plasma leakage.

Latar Belakang : Beberapa penelitian pada anak telah melaporkan bahwa peningkatan kadar sitokin pro-inflamasi, seperti interleukin-6 dan petanda inflamasi, seperti protein C reaktif berhubungan dengan kebocoran plasma pada infeksi dengue. Pada penderita dewasa hal ini masih belum jelas. Tujuan : Untuk mengetahui perbedaan kadar interleukin-6 dan protein C reaktif antara kelompok infeksi dengue dengan dan tanpa kebocoran plasma.

Metode : Penelitian potong lintang terhadap data sekunder dari penderita infeksi dengue dewasa yang dirawat di RSCM dan RSUP Persahabatan antara 1 Maret 2014 sampai 1 April 2015. Analisis dilakukan terhadap perbedaan kadar inter- leukin-6 dan protein C reaktif pada hari ke-3 dan 5 demam antara kelompok dengan dan tanpa kebocoran plasma, maupun perbedaan kadar antara hari ke-3 dan hari ke-5 demam pada tiap kelompok. Hasil : Jumlah total sampel yang diteliti adalah 44 orang, terdiri dari 24 orang dengan kebocoran plasma dan 20 orang tanpa kebocoran plasma. Nilai median kadar interleukin-6 untuk kelompok dengan dan tanpa kebocoran plasma masingmasing untuk hari ke-3 dan hari ke-5 demam adalah 8,56 vs 3,80 (p = 0,069) pg/mL dan 4,30 vs 2,76 pg/mL (p = 0,025), sedangkan untuk protein C reaktif

adalah 10,1 vs 6,8 mg/L (p = 0,014) dan 5,0 vs 2,9 mg/L (p = 0,048). Median kadar interleukin-6 pada hari ke-3 dan hari ke-5 demam pada kelompok dengan kebocoran plasma sebesar 8,56 vs 4,30 pg/mL (p = 0,037) dan pada kelompok tanpa kebocoran plasma adalah 3,80 vs 2,76 pg/mL (p = 0,005). Median kadar protein C reaktif pada hari ke-3 dan hari ke-5 demam pada kelompok dengan kebocoran plasma sebesar 10,1 vs 5,0 mg/L (p = 0,0001) dan pada kelompok tanpa kebocoran plasma sebesar 6,8 vs 2,9 mg/L (p = 0,0001). Simpulan : Tidak terdapat perbedaan kadar interleukin-6 pada hari ke-3 demam antara kedua kelompok, sedangkan pada hari ke-5 demam kadar interleukin-6 lebih tinggi pada kelompok dengan kebocoran plasma. Kadar protein C reaktif pada hari ke-3 dan hari ke-5 demam lebih tinggi pada kelompok dengan kebocoran plasma. Kadar interleukin-6 dan protein C reaktif pada hari ke-3 demam lebih tinggi dibandingkan hari ke-5 demam pada kelompok dengan dan tanpa kebocoran plasma.
Kata Kunci : interleukin-6 – protein C reaktif – dengue



Background : Some studies in children have reported elevated levels of proinflammatory cyto-kines, such as interleukin-6 and markers of inflammation, such as C-reactive protein associated with plasma leakage in dengue infection. In adults patients this is still unclear.

Objective : To determine differences in the levels of interleukin-6 and C-reactive protein among groups of dengue infection with and without plasma leakage. Methods

: A cross-sectional study of secondary data from adult patients with dengue infection were treated at Cipto Mangunkusumo and Persahabatan Hospital between March 1, 2014 until April 1, 2015. The analysis carried out on differences in levels of interleukin-6 and C-reactive protein on the 3 day of fever between groups with and without plasma leakage, as well as differences in levels between the 3 rd and the 5 th day of fever in each group. Results : The total number of samples studied were 44 people, consisting of 24 people with plasma leakage and 20 people without plasma leakage. Median levels of interleukin-6 for groups with and without plasma leakage each for the 3 and the 5 th day of fever were 8.56 vs 3.80 pg/mL(p = 0.069) and 4.30 vs 2.76 pg/mL (p = 0.025), whereas for C-reactive protein were 10.1 vs 6.8 mg/L ( p = 0.014) and 5.0 vs 2.9 mg/L (p = 0.048). Median levels of interleukin-6 on the 3 and the 5 th day of fever in the group with plasma leakage were 8.56 vs 4.30 pg/mL (p = 0.037) and in the group without plasma leakage were 3.80 vs 2.76 pg/mL (p = 0.005). Median level of C-reactive protein on the 3 ix rd and 5 th day of fever in the group with plasma leakage were 10.1 vs 5.0 mg/L (p = 0.0001) and in the group without plasma leakage were 6.8 vs 2.9 mg/L (p = 0.0001). Conclusions : There was no differences in levels of interleukin-6 on the 3 day of fever between the two groups, while on the 5th day of fever interleukin-6 levels was higher in the group with plasma leakage. The levels of C-reactive protein on the 3 rd and the 5 th day of fever were higher in the group with plasma leakage. The level of Interleukin-6 and C-reactive protein on the 3 rd day of fever were higher than the 5 th day of fever in both groups with and without plasma leakage.
Keywords : interleukin-6 – C-reactive protein - dengue