Perbandingan Kadar T3, T4, FT4, TSH pada Penderita Sirosis Hati Berdasarkan Childpugh Score

Abstract

Latar belakang: Sirosis hati merupakan stadium akhir dari penyakit hati akut dan kronis. Pada sirosis hati terjadi kerusakan sel-sel hati yang kemudian menjadi jaringan fibrosis. Hati berperan penting dalam metabolisme TSH. Hati merupakan organ yang paling penting dalam mengkonversi tetraiodothyronine (T4) ke triiodothyronine (T3) tipe 1 deiodinase. Selain itu, hati terlibat dalam konjugasi hormon tiroid dan ekskresi, serta sintesis tiroid binding globulin. T4 dan T3 mengatur tingkat metabolisme basal dari semua sel. Perubahan T3 berkorelasi dengan tingkat keparahan penyakit dan sebagai prognosis sirosis hati. Tujuan Penelitian: mengetahui perbedaan kadar T3, T4, FT4, TSH pada pasien sirosis hati berdasarkan ChildPugh A, B dan C dari bulan Oktober- November 2017. Metode Penelitian: dilakukan dengan desain cross sectional terhadap 40 penderita sirosis hati berdasarkan ChildPugh score. Dilakukan ultrasonografi dan pemeriksaan kadar T3, T4, FT4, TSH untuk mengetahui perbedaan antara pasien sirosis hati dengan ChildPugh A, B dan C dengan metoda ELISA. Hasil: Dari 40 subyek, 22 orang laki-laki (55%), 18 perempuan (45%), rerata umur 47,43 tahun, mayoritas bersuku batak 20 orang (50%), penderita sirosis hati berdasar ChildPugh A terdapat 6 orang (15%), 7 orang (17,5%) Childpugh B dan 27 orang (67,5%) ChildPugh C. Ditemukan rerata kadar T3 berdasarkan ChildPugh A (0,47 ± 0,46), ChildPugh B (0,54, ± 0,19), ChildPugh C (0,51 ± 0,18) dengan (p=0,861). Kadar T4 berdasarkan ChildPugh A (8,71 ± 2,95), ChildPugh B (4,80 ± 3,08), ChildPugh C (5,85 ± 3,76) dengan (p=0,063). Kadar FT4 berdasarkan ChildPugh A (0,97 ± 0,57), ChildPugh B (2,21 ± 3,89), ChildPugh C (1,14 ± 0,97) dengan (p=0,827). Kadar TSH berdasarkan ChildPugh A (1,49 ± 1,78), ChildPugh B (2,26 ± 1,67), ChildPugh C (1,65 ± 1,41) dengan (p=0,315). Kesimpulan: Tidak dijumpai perbedaan yang signifikan pada kadar T3,T4,FT4,TSH pada penderita sirosis hati berdasarkan ChildPugh score.

Background : Liver cirrhosis is the end stage of acute and chronic liver disease. In liver cirrhosis occurs liver cell damage which later became fibrosis tissue. Liver has important role in metabolism of TSH. The liver is the most important organ in converting tetraiodothyronine (T4) to triiodothyronine (T3) type 1 deiodinase. In addition, the liver is involved in thyroid hormone conjugation and excretion, as well as the synthesis of thyroid binding globulin. T4 and T3 regulate basal metabolic rate of all cells. T3 changes correlate with the severity of the disease and as a prognosis of liver cirrhosis. Objective : To investigate the differences in T3, T4, FT4, TSH levels in patients with liver cirrhosis based on ChildPugh A, B and C in the period between October-November 2017. Method: The study was conducted with a cross-sectional design in 40 patients with liver cirrhosis based Childpugh score. Ultrasonography and T3 levels, T4, FT4, TSH examinations done to know the difference between liver cirrhosis patients with ChildPugh A, B and C with ELISA method. Results: From 40 subjects, 22 men (55%), 18 women (4 5 %), the mean age was 47.43 years, the majority of the ethnic was Bataknese 20 people (5 0 %), liver cirrhosis patients based on ChildPugh A there were 6 people (15%), 7 people (17.5%) ChildPugh B and 27 people (67.5%) ChildPugh C. Found average T 3 levels based on ChildPugh A (0,47 ± 0,46), ChildPugh B (0,54, ± 0,19), ChildPugh C (0,51 ± 0,18) with (p = 0.861). level of T 4 based on ChildPugh A (8,71 ± 2,95), ChildPugh B (4,80 ± 3,08), ChildPugh C (5,85 ± 3,76) with (p = 0.063). Level of FT 4 based on ChildPugh A (0,97 ± 0,57), ChildPugh B (2,21 ± 3,89), ChildPugh C (1,14 ± 0,97) with (p = 0.827). Level of TSH based ChildPugh A (1,49 ± 1,78), ChildPugh B (2,26 ± 1,67), ChildPugh C (1,65 ± 1,41) with (p = 0.315). Conclusion: Not found significant differences in T 3, T 4, FT 4, TSH levels in patients with cirrhosis of the liver based on ChildPugh score.