"Tujuan: (1) mengetahui perubahan status protein dalam 5 hari pasca serangan stroke; (2) mengetahui faktor risiko, status gizi dan asupan energi dan protein selama dirawat; (3) mengetahui hubungan antara perubahan status protein dengan faktor risiko, status gizi dan asupan energi dan protein.
Tempat: Ruang rawat inap Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo.
Metodologi: Sebanyak 77 pasien diambil dengan diagnosis stroke iskemik dan hemoragik yang memenuhi kriteria perterimaan. Dilakukan pengukuran antropometri yaitu berar badan dan tinggi badan. Pemeriksaan laboratorium yang dilakukan yaitu kadar albumin plasma pada hari kel dan ke 5, NUU dan kleatinin urin dari urin tampttng 24 jam pada hari ke 1, 3 dart 5. Data asupan energi dan protein melalui oral, enteral dan parenteral selama 24 jam pada hari ke 1, 3 dan 5, hasil dianalisis dengan program Food Processor II. Imbang nitrogen diperoleh dengan menghitung asupan nitrogen dan NUU 24 jam. Hubungan antara parameter Status protein dengan faktor risiko diuji dengan uji One Way ANOVA/uji Kruskal Wallis. Hubungan antara parameter status protein dengan status gizi diuji dengan uji t berpasangan/uji Man Whitney U. Korelasi antara parameter status protein dengan asupan energi dan protein diuji dengan uji korelasi Spearman Rank.
Hasil: Hasil penelitian diperoleh 67,5% stroke iskemik dan 32,5% stroke hemomgik Faktor risiko yang didapat adalah hipertensi, diabetes melitus, kelainan jantung dan dislipidemia, faktor risiko dibagi menjadi faktor risiko terkontrol, tidak terkontrol dan belum ditemukan Fktor risiko. Median asupan energi dan protein masih dibawah kebutuhan. Terdapat penurunan bermakna Radar albumin hari ke 5 dan peningkatan NUU hari ke 3, tidak ada perbedaan bermakna kadar kreatinin urin. Imbang nitrogen negatif selama penelitian. Terdapat perbedaan bermakna kadar albumin antara kelompok pasien stroke iskemik dan stroke hemoragik. Tidak ada perbedaan bermakna parameter status protein antara ke 3 kelompok faktor risiko. Terdapat perbedaan bermakna kadar albumin hari ke 1 dan 5 serta kadar kreatinin urin hari ke 3 dan 5 antara kelompok pasien dengan status gizi normal dan berat badan lebih,.Terdapat korelasi lemah antara parameter status protein dengan asupan energi dan protein. Korelasi lemah sampai sedang terdapat antara imbang nitrogen dengan asupan energi dan protein.
Kesimpulan: Penelitian ini menunjukkan terdapat penurunan status protein pada pasien stroke. Terdapat penurunan bermakna kadar albumin, hari ke 5, peningkatan nilai NUU hari ke 3, tidak ada perubahan kadar kreatinin urin, imbang nitrogen negatif selama penelitian.
Objective: (1) to investigate the changes of protein slams within 5 days alter stroke, (2) to observe the risk factors, nutritional status, energy and protein intake, and analyze the correlation with protein indicators, (3) to analyze the correlation between protein indicators with energy and protein intake.
Location: Ci ptolvlangunkusumo General Hospital, Jakarta.
Subject and Methods: Seventy seven patients with acute stroke were recruit as the subjects of the study. Anthropometry assessments i.e body weight and height were assmsed in the 1st day of admission. Laboratory assessment i.e albumin were assessed in the 1' and 5?? day. Urinary urea nitrogen (UUN) and urinary creatinine were assessed in the 1st, 3rd and 5th day using 24-hour urine collection. Energy and protein intake from parenteral, enter-al and oral route were calculated in the 1st, 3rd and 5th day and analyzed by Food Processor ll program. Nitrogen balanced was calculated by substracting nitrogen intake with urinary nitrogen. The correlation between protein indicators with risk factors was tsted using One Way ANOVA/Kruskal Wallis test. The correlation between protein indicators with nutritional status was tested using t test/Man Whitney U test. The correlation between protein indicators with energy and protein intake was tested using Spearman Rank Correlation.
Results: The type of stroke determined by clinical diagnosis were; ischemic stroke 615% and hemorrhagic stroke 32,5%. Risk factors found ofthe subjects were: hypertension, diabetes mellitus, cardiac disease, hypercholesterolemia and unknown risk lilctors. The risk factors were grouped into 3 categories; controlled risk factors, uncontrolled risk factors and unknown risk factors. The median intake of energy and protein were below the requirement There were significant decrease in serum albumin in the 5th day and increase in UUN in the 3rd day, and no significant difference in urinary creatinine. During the study, there were negative nitrogen balance. No significant difference in protein indicators between risk factors group. There were significant difference in protein indicators between ischemic and hemorrhagic stroke, and significant difference in serum albumin and urinary creatinine between normal weight and overweight There was no correlation significant between protein indicators and energy and protein intake using Spearman Rank correlation The correlation between protein indicators and nitrogen balance was significant.
Conclusions: The current study indicates that there was decreases of protein status in stroke patients. There were significant decrease in serum albumin in the 5th day and increase in UUN in the 3rd day, and there were negative nitrogen balance during the study."
