Latar belakang: Diabetes melitus merupakan faktor risiko penting terjadinyaaterosklerosis, aterosklerosis merupakan penyakit sistemik yang bisa terjadi di seluruhpembuluh darah baik pada mikrovaskular maupun makrovaskular. Adanya buktiiskemia akibat stenosis yang disebabkan aterosklerosis pada salah satu pembuluh darah,mengharuskan kita lebih waspada akan adanya proses aterosklerosis di tempat lain.NPD di kaki terjadi akibat komplikasi diabetes pada mikrovaskular yang akhirnyamengakibatkan kerusakan pada persarafan di kaki. Maka perlu mewaspadai prosesateroslerosis di tempat lain, baik pada pembuluh arteri makro maupun mikrovaskular dikaki. Pemeriksaan non invasif untuk melihat adanya ganguan makrovaskular di kakimenggunakan ABI dan TBI sedangkan untuk gangguan mikrovaskular dengan TcPO2.Penelitian ini dilakukan untuk dapat menilai hubungan derajat neuropati perifer diabetikyang dinilai dengan TCSS dengan proses ateroskerosis dipembuluh darah kaki, baikyang makrovaskular dengan ABI dan TBI maupun mikrovaskular TcPo2 pada pasienDM tipe 2.Metode: Penelitian potong lintang dilakukan pada pasien DM tipe 2 dengan NPDdengan nilai TCSS >5 di Poliklinik Pelayanan Jantung Terpadu, poliklinik Endokrindan Metabolik dan Poliklinik Ilmu Penyakit Dalam Umum RSCM. Data diperoleh dariwawancara, rekam medik, pemeriksaan ABI, TBI dan TcPO2. Variabel penelitianberupa derajat neuropati perifer, ABI, TBI dan TcPO2. Analisis bivariat terhadapmasing-masing variable dengan menggunakan uji Spearman.Hasil: Sebanyak 36 subjek yang memenuhi kriteria pemilihan diikutkan dalampenelitian, rerata usia 62 tahun dengan 20 (55,6%) di antaranya perempuan dan medianlama diabetes 12 tahun. Berdasarkan analisa bivariat dengan uji spearman penelitian inimendapatkan korelasi negatif yang bermakna secara statistik dengan koefisien korelasisedang antara derajat neuropati perifer diabetik yang dinilai dengan TCSS dengan ABI(r = -0,475, p = 0,003) dan TBI (r = -0,421, p = 0,010). Dan pada pemeriksaan TcPO2juga di dapatkan korelasi negatif yang bermakna secara statistik dengan koefisienkorelasi sedang ( r = -0,399, p = 0,016)Simpulan : Terdapat korelasi negatif yang bermaksa secara statistik antara derajatneuropati perifer diabetik dengan ABI, TBI dan TcPO2.
Background: Diabetes mellitus is important risk factor of atherosclerosis.Atherosclerosis is systemic disease that can occur in all blood vessels bothmicrovascular and macrovascular. There is evidence of ischemia due to stenosis causedby atherosclerosis in one blood vessel, which requires us to be more aware with theprocess of atherosclerosis in other places. Diabetic peripheral neuropathy (DPN) in thelower extremity results from complications of diabetes in the microvascular which candamage nerve in the lower extremity. Then it is necessary to be aware of the process ofaterosclerosis elsewhere, both in the macro and microvascular arteries in the lowerextremity. Non-invasive examination to look macrovascular disorders in the lowerextremity are using ankle brachial index (ABI) and toe brachial index (TBI) while formicrovascular disorders with TcPO2. This study was conducted to assess theassociation of the degree of diabetic peripheral neuropathy assessed by toronto clinicalscoring system (TCSS) with the process of atherosclerosis in the blood vessels of thelower extremity, both macrovascular with ABI and TBI as well as microvascular TcPo2in Patients with type 2 diabetes mellitus (DM)Methods: Cross-sectional study was carried out in patients with type 2 DM with DPNwith TCSS values> 5 in the Integrated Cardiac Polyclinic, Endocrine and MetabolicPolyclinic, and Internal Medicine Polyclinics at RSCM. The Data were obtained frominterviews, medical records, ABI, TBI and TcPO2 examinations. The research variablesare the degree of peripheral neuropathy, ABI, TBI and TcPO2. Bivariate analysis ofeach variable was used the Spearman test.Results: Total of 36 subjects who met the selection criteria were included in the study,the average age was 62 years with 20 (55.6%) of whom were women and the medianduration of diabetes was 12 years. Based on bivariate analysis with the Spearman test,this study found a statistically significant negative correlation with moderate correlationcoefficient between the degree of diabetic peripheral neuropathy assessed by TCSS withABI (r = -0.475, p = 0.003) and TBI (r = -0.421, p = 0.010) . The TcPO2 examinationalso found a statistically significant negative correlation with moderate correlationcoefficient (r = -0.399, p = 0.016)Conclusion : There is a statistically significant negative correlation between the degree of diabetic peripheral neuropathy with ABI, TBI and TcPO2 examinations. |
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