Hubungan Kadar Matriks Metaloproteinase-2 Serum dan Skor Aspartate To Platelet Ratio Index untuk Menilai Fibrosis Hati antara Penyandang Thalassemia yang Mendapat Terapi Kelasi Besi Deferoksamin dan Deferipron
Sari
Latar belakang. Penyandang thalassemia secara progresif akan mengalami keadaan kelebihan besi yang dapat menyebabkan terbentuknya peroksidase lipid dan merusak sel hati sehingga terbentuk fibrosis hati. Terapi kelasi besi bertujuan untuk mengurangi kelebihan besi.
Tujuan. Mengetahui hubungan kadar MMP-2 serum dan peningkatan skor APRI untuk menilai fibrosis hati antara penyandang thalassemia yang mendapat terapi kelasi besi deferoksamin dengan deferipron.
Metode. Penelitian potong lintang dilaksanakan dari Juli–Agustus 2013, dilibatkan 42 penyandang thalassemia usia 2,5–14 tahun yang mendapat terapi kelasi besi deferoksamin dan deferipron. Kadar MMP-2 serum diperiksa dengan metode ELISA dan perhitungan skor APRI dengan Rumus Wai. Perbedaan dan korelasi ditentukan antara varibel dengan uji Mann-Whitney dan Rank Spearmann. Analisis kovariat digunakan untuk menghilangkan faktor perancu.
Hasil. Terdapat 44 subjek, 22 mendapat terapi kelasi besi deferoksamin dan 22 deferipron. Kadar MMP-2 serum kelompok deferipron lebih rendah (130ng/mL) dibandingkan deferoksamin (314ng/mL). Skor APRI kelompok deferipron rata-rata lebih tinggi (1,584) dibanding deferoksamin (0,575). Perbedaan skor APRI dan kadar MMP-2 serum kedua kelompok sangat bermakna (p<0,001). Terdapat korelasi negatif antara kadar MMP-2 serum dan skor APRI, yaitu semakin tinggi skor APRI maka semakin rendah kadar MMP-2 serum penyandang thalassemia yang mendapat terapi kelasi besi deferipron dan deferoksamin (r=-0,726, p=<0,001).
Kesimpulan. Penurunan kadar MMP-2 serum dan peningkatan skor APRI untuk menilai fibrosis hati pada kelompok terapi kelasi besi deferipron lebih tinggi dibandingkan dengan kelompok deferoksamin serta terdapat korelasi negatif antara kadar MMP-2 serum dan skor APRI
Kata Kunci
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DOI: http://dx.doi.org/10.14238/sp16.1.2014.57-63
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