Tesis

Hubungan Kecukupan Energi dan Protein Harian Terhadap Perubahan Nilai Rasio Neutrofil Limfosit Pada Pasien Stroke Iskemik Selama Rawatan di RSUPN Dr. Cipto Mangunkusumo. = Relationship between Daily Energy and Protein Adequacy and Changes in Neutrophil Lymphocyte Ratio in Ischemic Stroke Patients During Hospitalization at Dr. Cipto Mangunkusumo Hospital.

Rasio neutrofil limfosit (RNL) adalah salah satu biomarker prognostik yang sudah banyak dipakai untuk memprediksi luaran klinis berbagai penyakit. Nilai RNL yang tinggi berhubungan dengan luaran klinis yang buruk pada pasien stroke iskemik. Asupan energi dan protein yang cukup selama rawatan di rumah sakit (RS) dapat membantu menurunkan kadar RNL yang tinggi saat admisi. Asupan nutrisi yang cukup selama rawatan membantu mempertahankan sistem imun, meningkatkan proliferasi limfosit dan produksi antibodi. Penelitian ini bertujuan untuk melihat hubungan kecukupan energi dan protein selama rawatan di RS terhadap perubahan nilai RNL pada pasien stroke iskemik di RSCM dan RSUI. Penelitian menggunakan desain kohort prospektif pada subjek berusia ≥ 18 tahun yang dirawat di RSCM dan RSUI. Diperoleh 52 subjek dengan kelompok cukup asupan energi dan protein sebanyak 26 subjek dan kelompok yang tidak cukup sebanyak 26 subjek. Rerata usia subjek 62,34 + 11,8, laki – laki 61,5%, subjek dengan status nutrisi obesitas derajat 1 berdasarkan indeks massa tubuh (IMT) 23,1%, dan faktor risiko hipertensi sebanyak 82,7%. Tidak terdapat hubungan bermakna antara kecukupan energi dan protein dengan penurunan nilai RNL selama rawatan. Namun, sebagian besar subjek yang mendapat asupan cukup energi dan protein mengalami penurunan nilai RNL. Penelitian lanjutan diperlukan dengan menggunakan subjek lebih banyak dan menganalisis faktor – faktor lain yang dapat memengaruhi penurunan nilai RNL dan asupan makan pada pasien stroke iskemik yang dirawat.
Kata Kunci: Stroke, energi, protein, rasio neutrofil limfosit (RNL)


Neutrophil-lymphocytes ratio (NLR) is one of the prognostic biomarkers that has been widely used to predict clinical outcomes of various diseases. High NLR values are associated with poor clinical outcomes in ischemic stroke patients. Adequate energy and protein intake during hospitalization can help reduce high NLR levels at admission. Adequate nutritional intake during treatment helps maintain the immune system, increase lymphocyte proliferation and antibody production. This study aims to look at the relationship between energy and protein adequacy during hospitalization and changes in NLR values in ischemic stroke patients at RSCM and RSUI. The study used a prospective cohort design on subjects aged ≥ 18 years who were hospitalized at RSCM and RSUI. Total 52 subjects and then divided into two groups, an adequate energy and protein groups 26 subjects and an insufficient groups 26 subjects. The mean age of the subjects was 62.34 + 11.8, male 61.5%, subjects with nutritional status of grade 1 obesity based on body mass index (BMI) 23.1%, and risk factors for hypertension were 82.7%. There was no significant relationship between energy and protein adequacy group and the decrease in NLR values during hospitalization. However, most subjects who received energy and protein adequate experienced a decrease in NLR. Further research is needed by using more subjects and analyzing other factors that can affect the decrease in NLR value and food intake in stroke patients during hospitalization.
Keywords: Stroke, energy, protein, neutrophil-lymphocyte ratio (NLR)