Tesis

Gangguan Kapasitas Difusi Paru pada Mikroangiopati Diabetik di RSUP Persahabatan Jakarta = Lung diffusion capacity impairment in diabetic microangiopathy at Persahabatan Hospital Jakarta.

Latar Belakang: Mikroangiopati diabetik (DM) seperti nefropati, retinopati, dan neuropati merupakan komplikasi umum diabetes melitus tipe 2 (T2DM). Paru merupakan salah satu organ target dari komplikasi mikrovaskular dan penurunan kapasitas difusi paru pada mikroangiopati DM masih sedikit diketahui. Tujuan: Mengetahui kapasitas difusi paru pada mikroangiopati DM di Rumah Sakit Persahabatan Jakarta. Metode: Penelitian ini bersifat potong lintang pada subjek T2DM yang menjalani pemeriksaan kapasitas difusi paru terhadap karbon monoksida (DLCO), albumin urin, funduskopi dan elektromiografi (EMG) di poliklinik rawat jalan DM terpadu. Kriteria eksklusi yaitu penyakit paru akut atau kronis. Hasil: Sebanyak 52 subjek (L/P:20/32 usia 58±10,4 tahun) sebagian besar menunjukkan HbA1c>6,5% 41/52(78%), tidak pernah merokok 41/52(78,8%). rerata terdiagnosis DM 10,5±6,9 tahun, sebanyak 33(63,5%) ≤10 tahun dan 19(36,5%) subjek >10 tahun. Subjek dengan neuropati lebih banyak ditemukan yaitu sebesar 41/52 (26,3%) diikuti nefropati 29/52(18,6%) dan retinopati 9/52(5,8%) dengan rerata DLCO sebesar 16,01±4,12(ml/menit/mmHg). Penurunan kapasitas difusi pada Mikroangiopati DM ditemukan sebanyak 14/52(25%) subjek, didapatkan nilai p pada nefropati sebesar p=0,27, retinopati p=0,36 dan neuropati p=0,49. Kesimpulan: Gangguan kapasitas difusi paru pada mikroangiopati DM mengalami penurunan namun tidak mempunyai hubungan yang yang bermkana, hal ini menunjukkan gangguan faal difusi paru pada mikroangiopati DM.
Kata kunci: Mikroangiopati diabetes, diabetes melitus, kapasitas difusi paru.


Background: Diabetic microangiopathy such as nephropathy, retinopathy and neuropathy is a common complications of type 2 diabetes mellitus (T2DM). The lung is one of the target organs in the development of vascular complications in diabetic patients and little is known about the impairment of pulmonary diffusing capacity due to diabetic microangiopathy. Objective: The aim of this study was to investigate the pulmonary diffusing capacity tests among patients with T2DM at the Persahabatan Hospital. Methods: The subject were T2DM patients underwent carbon monoxide lung diffusion capacity (DLCO) test, urine test, funduscopy and electromyography (EMG) examination with consecutively from diabetic outpatient clinic. The exclusion criterias were acute or chronic pulmonary diseases. Results: A total of 52 subjects (m/f: 20/32 ages 58±10.4 years) mostly showed HbA1c> 6.5% 41/52 (78%), never smoked 41/52 (78.8%). diagnosed DM rates of 10.5±6.9 years, 33 (63.5%) ≤10 years and 19 (36.5%) subjects> 10 years. Subjects with more neuropathy were 41/52 (26.3%) followed by nephropathy 29/52 (18.6%) and retinopathy 9/52 (5.8%) with DLCO average of 16.01±4.12 (ml/min/mmHg). The decrease in diffusion capacity in Microangiopathy DM was found in 14/52 (25%) subjects, obtained p value on nephropathy of p=0.27, retinopathy p=0.36 and neuropathy p=0.49 respectively. Conclusion: This study demonstrated that diffusion capacity is impairment in diabetic microangiopathy patients. Lung diffusion capacity has no association with diabetic microangiopathy but there is a decreased pulmonary diffusion physiology.
Keywords: Diabetic microangiopathy, diabetes mellitus, carbon monoxide lung diffusion capacity.