ABSTRAK
Latar Belakang. Lupus Eritematosus Sistemik (LES) merupakan penyakitautoimun multisistem mengenai multiorgan akibat produksi antibodi dan kompleksimun. Memiliki mortalitas 3 kali lebih tinggi dibandingkan populasi umum dimanasaat awal berkaitan dengan infeksi dan inflamasi, sedangkan jangka panjangberkaitan dengan aterosklerosis. Adapun aterosklerosis yang terjadi timbul lebihcepat dan faktor risiko tradisional (diabetes melitus, hipertensi, hiperkolesterol,obesitas, merokok dan lainnya) dan terapi steroid belum dapat menjelaskan hal ini.Diduga kompleks OxLDL/β2GP1 memainkan peranan dalam proses imunopatologiterjadinya aterosklerosis dan trombosis yang dimediasi oleh adanya penyakitautoimun.Metode. Desain penelitian berupa studi potong lintang. Subyek penelitian adalahpasien LES poliklinik Imunologi RSUPN Ciptomangunkusomo Jakarta yang telahdilakukan pemeriksaan Carotid Duplex dan Transcranial Doppler, serta memenuhikriteria inklusi dan eksklusi. Subyek diperoleh secara konsekutif. Pada subyekdilakukan wawancara, pengisian kuesioner, pemeriksaan fisik umum dan neurologi,dan pengambilan darah vena untuk diperiksa kompleks OxLDL/β2GP1. Dilakukananalisis data menggunakan perangkat SPSS 17.0Hasil. Diperoleh 40 subyek pasien LES wanita tanpa drop out. Kadar kompleksOxLDL/β2GP1 pada pasien LES dengan aterosklerosis dan tanpa aterosklerosismasing-masing meannya 0,37 unit/ml dan 0,31 unit/ml. Berdasarkan beberapa faktorrisiko tradisional aterosklerosis (usia, LDL, DM, hipertensi dan obesitas) didapatkankadar kompleks OxLDL/β2GP1 pada pasien aterosklerosis maupun tidak, memilikimean >0,25 unit/ml.Kesimpulan. Pasien LES dengan atau tanpa aterosklerosis memiliki kadar kompleksOxLDL/β2GP1 lebih dari 0,25 unit/ml namun tidak terdapat perbedaan bermakna.Demikian pula pada aterosklerosis yang disertai atau tanpa disertai faktor risikotradisional.
ABSTRACT
Background. Systemic Lupus Erythematous (SLE) is a multisystem autoimmunedisease that can affect various organs due to production of antibodies and immunecomplexes. The mortality rate of SLE patients is three times higher than the generalpopulation. In early disease, mortality is related to infection and inflammation,whereas in advanced stage it is related to atherosclerosis. In SLE, atherosclerosisoccurs faster; however the traditional risk factors (diabetes mellitus (DM),hypertension, hypercholesterolemia, obesity, smoking, etc.) and steroid therapyhave not been able to explain this phenomenon. It is hypothesized that theOxLDL/β2GP1 complexes play roles in the immunopathological process ofatherosclerosis and thrombosis that is mediated by the presence of autoimmunedisease.Method. A cross-sectional study was conducted. The study subjects were SLEpatients from immunology clinic of Cipto Mangunkusumo Hospital, Jakarta whopreviously have underwent carotid duplex and transcranial Doppler examination andalso met the inclusion and exclusion criteria. Subjects were obtained consecutively;they were interviewed, asked to fill questionnaire, underwent general andneurological physical examination, and their venous blood samples were collected.Data analysis were done by using SPSS 17.0.Result. A total of 40 SLE patients were included in this study; all subjects werefemale and there were no drop out cases. The mean of OxLDL/β2GP1 complexeslevel in SLE patients with and without atherosclerosis were 0,37 unit/ml and 0,31unit/ml, consecutively. Based on several traditional risk factors for atherosclerosis(age, LDL, DM, hypertension and obesity), the mean of OxLDL/β2GP1 complexeslevel in patients with and without atherosclerosis is > 0,25 unit/ml.Conclusion. SLE patients with or without atherosclerosis have level ofOxLDL/β2GP1 complexes of more than 0,25 unit/ml, but there were no significantdifference. Similar results were found in atherosclerosis with or without traditionalrisk factors. |
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