INTERLEUKIN 10 MASA AKUT DAN ASAM URAT PADA CEDERA OTAK TRAUMATIK SEDANG DAN BERAT: PENELITIAN PENDAHULUAN

Abstract

Pendahuluan: Inflamasi pada cedera otak traumatik (COT) berhubungan dengan peningkatan interleukin 10 (Il-10) dan asam urat (AU) namun interaksinya belum banyak diteliti. Tujuan: Mengetahui hubungan kadar AU dan Il-10 masa akut (<24 jam) dengan luaran COT sedang dan berat. Metode : Penelitian kohort prospektif di RSUP Prof. dr. R.D. Kandou Manado (RS RDK). Subjek adalah pasien COT sedang dan berat, berusia >16 tahun, dan mengalami COT dengan awitan yang jelas <24 jam. Subjek dieksklusi jika memiliki penyakit infeksi aktif dan kondisi lain yang dapat mempengaruhi hasil pemeriksaan Il-10 dan AU. Pemeriksaan skala koma Glasgow (SKG), kadar AU awal, dan Il-10 dilakukan dalam waktu <24 jam setelah pasien masuk. Pemeriksaan kadar AU kontrol dilakukan pada hari rawat ke-4/ke-5. Selanjutnya dihitung selisih kadar AU kontrol dan awal. Subjek dirawat sesuai alur klinis COT sedang dan berat RS RDK. Saat keluar rumah sakit dilakukan evaluasi luaran pasien menggunakan skala luaran Glasgow (SLG).  Hasil: Didapatkan 50 subjek yang didominasi laki-laki (n = 43; 86%) bermedian usia 26 tahun. SKG berkorelasi positif dengan SLG sedangkan leukosit dan Il-10 masa akut berkorelasi negatif. Perubahan AU tidak memiliki korelasi yang bermakna dengan SLG namun kadar AU awal berkorelasi dengan meningkatnya kadar Il-10 fase akut.

Kata kunci : Cedera otak traumatik, interleukin 10, asam urat, skala luaran Glasgow

ABSTRACT

Background: Inflammation in traumatic brain injury (TBI) is associated to the increase of interleukin 10 (Il-10) and uric acid (UA) but the interaction is rarely studied. Aim: To find the correlation between UA level and acute phase (<24 hours) Il-10 and the outcome of moderate to severe TBI. Method: A prospective cohort study in R.D. Kandou Hospital Manado (RS RDK). Subjects were moderate and severe TBI patients, age >16 years old, and had a clear TBI onset of <24 hours. Subject was excluded if having an active infectious disease or other conditions that could influence the result of Il-10 and UA examinations. Glasgow scoma scale (GCS), initial UA level, and Il-10 were examined <24 hours before admission. Control UA was examined on the 4-th/5-th admission day. The initial and control UA level was then calculated. Subjects were treated according to the hospital’s moderate and severe TBI clinical pathway. Subjects’ outcomes were evaluated on discharge using Glasgow outcome scale (GOS).  Result: We founf 50 subjects who were mostly male (n = 43, 86%) with median age of 26 years old. GCS was positively correlate to GOS whole leucocyte and acute phase Il-10 have negative correlations. UA difference has no significant correlation with GOS but initial UA level has a correlation with the increase of acute phase Il-10.

Keywords: Traumatic brain injury, interleukin 10, uric acid, Glasgow outcome scale