Tesis

Perubahan High Sensitive-C Reactive Protein dan Sitokin Inflamasi pada Pasien Bedah Pintas Arteri Koroner Lansia serta Kaitannya dengan Lama Rawat di ICU = Changes in High Sensitivity C-Reactive Protein and Inflammatory Cytokines in Elderly Coronary Artery Bypass Surgery Patients and Their Relationship with Length of ICU Stay.

High sensitivity C-reactive protein (hs-CRP) adalah sebuah protein fase akut yang dihasilkan oleh hati dan dilepaskan sebagai respons terhadap stimulasi IL-6 yang berperan sebagai prediktor independen yang kuat dalam mengindikasikan risiko aterosklerosis. Sitokin adalah protein kecil yang diproduksi oleh sel T helper (Th) dan makrofag untuk memengaruhi respon imun. Sitokin yang diteliti dibedakan menjadi 2, yaitu sitokin pro-inflamasi (IL-6 dan IL-8) dan sitokin anti-inflamasi (IL-10). Penelitian ini bertujuan untuk mengetahui perubahan hs-CRP dan sitokin inflamasi pada pasien lansia usia di atas 60 tahun yang melakukan operasi bedah pintas arteri koroner di RS. Pusat Jantung Nasional Harapan Kita serta kaitannya dengan lama rawat di ICU, sehingga dapat menjadi indikator pengurangan risiko komplikasi pasca-operasi. Konsentrasi hs-CRP dan sitokin inflamasi dianalisis dari plasma darah dengan metode ELISA dan Luminex. Hasil penelitian menunjukkan bahwa terdapat perbedaan bermakna kadar hs-CRP, IL-6, dan IL-8 antar kelompok pra-operasi dan pasca-operasi. Terdapat korelasi positif antar kadar plasma darah sitokin pro-inflamasi (IL-8) terhadap lama rawat di ICU, dengan koefisien korelasi= 0,459 dan nilai relative risk sebesar 2,7 artinya berindikasi 2,7 kali beresiko terhadap perpanjangan lama rawat di ICU. Hs-CRP dan sitokin inflamasi baik praoperasi dan pasca-operasi berpengaruh terhadap kelompok usia, jenis kelamin, faktor risiko DM, dan riwayat merokok.
Kata Kunci : hs-CRP, sitokin, interleukin, aterosklerosis, inflamasi


High sensitivity C-reactive protein (hs-CRP) is an acute-phase protein produced by the liver and released in response to IL-6 stimulation, serving as a strong independent predictor of atherosclerosis risk. Cytokines are small proteins produced by helper T cells (Th) and macrophages to influence the immune response. The cytokines studied are divided into two categories: pro-inflammatory cytokines (IL-6 and IL-8) and anti-inflammatory cytokines (IL-10). This study aims to determine changes in hs-CRP and inflammatory cytokines in elderly patients over 60 years old undergoing coronary artery bypass surgery at the National Cardiac Center Harapan Kita Hospital and their relationship with ICU length of stay, thereby serving as indicators for reducing the risk of postoperative complications. The concentrations of hs-CRP and inflammatory cytokines were analyzed from blood plasma using ELISA and Luminex methods. The results showed significant differences in levels of hs-CRP, IL-6, and IL-8 between preoperative and postoperative groups. There was a positive correlation between plasma levels of the pro-inflammatory cytokine IL-8 and the length of ICU stay, with a correlation coefficient of 0.459 and a relative risk value of 2.7, indicating a 2.7 times higher risk of prolonged ICU stay. Both preoperative and postoperative hs-CRP and inflammatory cytokines were influenced by age group, gender, diabetes mellitus risk factors, and smoking history.
Keyword : hs-CRP, cytokines, interleukins, atherosclerosis, inflammation