ABSTRAK
Latar Belakang. Prevalensi penyakit arteri perifer (PAP) pada pasien diabetesmelitus lebih tinggi dibandingkan populasi umum. Penyakit arteri perifer dapatmeningkatkan mortalitas dan morbiditas terutama akibat penyakit kardiovaskularpada pasien diabetes melitus tipe 2 (DM tipe 2). Tidak semua pasien dengan PAPdapat terdeteksi dengan pengukuran ankle brachial index (ABI) istirahat, sehinggadiperlukan pemeriksaan ABI treadmill. Pemeriksaan ABI treadmill dapatmendeteksi PAP pada fase awal, sehingga profil pasien pada kelompok iniberbeda dengan klompok PAP yang dideteksi dengan ABI istirahat. Diketahuinyaprofil pasien PAP ini penting untuk membantu meningkatkan kewaspadaanpasien, khususnya pasien DM tipe 2.Tujuan. Mengetahui profil pasien DM tipe 2 dengan PAP yang dideteksi denganABI treadmill.Metode. Penelitian dengan desain potong lintang dilakukan di PoliklinikMetabolik Endokrin dan Kardiologi, Departemen Ilmu Penyakit Dalam, RumahSakit Cipto Mangunkusumo pada Februari sampai April 2016 dengan metodesampling konsekutif. Subjek dengan nilai ABI istirahat normal/ perbatasanmenjalani treadmill dengan protokol Bruce yang digunakan juga sebagai protokoluji latih jantung treadmill. Diagnosis PAP ditegakkan bila terdapat penurunannilai ABI lebih dari 20% dibandingkan ABI istirahat.Hasil. Sebanyak 92 subjek dianalisis untuk mengetahui profil pasien DM tipe 2dengan PAP yang dideteksi dengan ABI treadmill. Lima belas subjek (16,3%)didiagnosis PAP. Kelompok PAP memiliki persentase subjek dengan durasidiabetes ≥ 10 tahun sebanyak 53,3%; dislipidemia sebanyak 73,3%; penyakitginjal kronik (PGK) sebanyak 33,3%; perokok sebanyak 40%; komplikasineuropati sebanyak 53,3%; albuminuri sebanyak 53,3%; retinopati sebanyak 40%;dan respons iskemia jantung positif/sugestif positif sebanyak 40% subjek.Sedangkan kelompok tanpa PAP memiliki subjek dengan durasi diabetes ≥ 10tahun sebanyak 33,8%; dislipidemia sebanyak 57,1%; PGK sebanyak 19,5%;perokok sebanyak 32,5%; komplikasi neuropati sebanyak 37,7%; albuminurisebanyak 26,4%; retinopati sebanyak 28,6%; respons iskemia jantungpositif/sugestif positif sebanyak 28,5% subjek.Kesimpulan. Prevalensi PAP yang dideteksi dengan ABI treadmill pada pasienDM tipe 2 adalah 16,3% (IK 95%: 8-23%). Kelompok PAP yang dideteksi denganABI treadmill memiliki subjek dengan durasi DM ≥ 10 tahun, dislipidemia,perokok, PGK, neuropati, albuminuria, retinopati dan respons iskemia jantungpositif/sugestif positif lebih banyak daripada subjek tanpa PAP.
ABSTRACT
Background. The prevalence of peripheral arterial disease (PAD) among diabetespatients was higher compared to general population. PAD increases morbidity andmortality, especially due to cardiovascular disease, in type 2 diabetes mellituspatients (T2DM). Not all patients having PAD could not be detected by restingankle brachial index (ABI) measurement, hence it is required treadmill ABIexamination. The examination enable to detect PAD in the earlier phase,therefore patients profile would different with PAD patient detected from restingABI examination. The profiles are important to raise the awareness of T2DMpatients.Aim. To identify profile T2DM patients with PAD detected by treadmill ABI.Methods. A cross-sectional study was carried out in Metabolic Endocrine andCardiology Outpatient Clinic, Internal Medicine Department, CiptoMangunkusumo Hospital during February-April 2016. The study usedconsecutive sampling method. Subject having normal or borderline resting ABIvalue is examine using Bruce protocol treadmill. The protocol is also used as acardiac treadmill exercise test protocol. The patients diagnose as PAD if there is areducing ABI value more than 20% compared to resting ABI.Result. The profile of PAD patients detected by treadmill ABI were obtain from92 subjects. Fifteen subjects (16,3%) were diagnosed having PAD. In the groupwith PAD, the percentage of subject with diabetes duration ≥ 10 years was 53,3%;dyslipidemia was 73.3%; chronic kidney disease (CKD) was 33.3%; smokers was40%; complications of neuropathy was 53.3%; albuminuri was 53.3%;retinopathy was 40%; positive / positive suggestive cardiac ischemia response was40% . Meanwhile the group without PAD, the percentage of subjects withdiabetes duration ≥ 10 years was 33.8%; dyslipidemia was 57.1%; CKD was19.5%; smokers was 32.5%; complications of neuropathy was 37.7%; albuminuriwas 26.4%; retinopathy was 28.6%; positive / positive suggestive cardiacischemia response was 28.5%.Conclusion. The prevalence of PAD that detected by treadmilll ABI in T2DMpatients is 16,3% (95% CI: 8-23%). The Group with PAD detected by ABItreadmill which have duration of diabetes ≥ 10 years, dyslipidemia, smokers,CKD, neuropathy, albuminuria, retinopathy, and the positive result on treadmillexercise test have more subjects than group without PAD. |
SP-Chandra Sari.pdf :: Unduh