Hubungan Rasio Neutrofil Limfosit dan Interleukin-34 terhadap Derajat Aktifitas Penyakit Lupus Eritematosus Sistemik

Abstract

Background. Systemic lupus erythematosus (SLE) is a chronic inflammatory disease with a broad spectrum of clinical and serological manifestations caused by autoantibody production, complement activation, and immune complex deposition. A number of studies have shown that neutrophil-lymphocyte and platelet-lymphocyte ratio are closely correlated with systemic lupus erythematosus and its disease activity, so that they can be used as diagnostic indicators and monitoring systemic lupus erythematosus disease activity. Aim. To determine the relationship between the ratio of neutrophil lymphocytes and the ratio of platelet lymphocytes to the degree of activity of lupus disease in patients with systemic lupus erythematosus. Method. This study is an observational analytic study using medical data from central installation patients at H.Adam Malik Hospital in the period January 2019 to December 2019. The sample was calculated using the unpaired comparative sample size formula for more than two groups one measurement. Then the distribution test was carried out with the Shapiro Wilk test. Bivariate analysis was conducted to determine the relationship between the ratio of lymphocytes to neutrophils and the ratio of lymphocytes to platelets with the MEX SLEDAI score using the ANOVA test if the data was normally distributed, or the Kruskal-Wallis test if the data was not normally distributed. Then proceed with the Mann Whitney post hoc test to see which groups have differences. The magnitude of the desired deviation (α) is 0.05, statistically significant if p<0.05. Results. 120 people participated in the study and there were 33 people (27.5%) with mild systemic lupus erythematosus, 47 people (39.2%) moderate degrees, and 40 people (33.3%) severe degrees. The neutrophil-lymphocyte ratio was associated with the degree of lupus activity in patients with systemic lupus erythematosus (p=0.001) and the platelet-lymphocyte ratio was associated with the degree of lupus activity in systemic lupus erythematosus. Conclusion. The neutrophil-lymphocyte ratio and the platelet ratio are related to the degree of lupus activity in patients with systemic lupus erythematosus.

Latar Belakang. Lupus eritematosus sistemik (systemic lupus erythematous, SLE) adalah penyakit inflamasi autoimun kronis dengan spektrum manifestasi klinis dan serologis yang luas yang disebabkan oleh produksi autoantibodi, aktivasi komplemen, dan deposisi kompleks imun. Sejumlah penelitian telah menunjukkan bahwa rasio neutrofil-limfosit dan rasio platelet-limfosit berkorelasi erat dengan lupus eritematosus sistemik dan aktivitas penyakitnya, sehingga dapat digunakan sebagai indikator diagnostik dan pemantauan lupus eritematosus sistemik.Tujuan. Mengetahui hubungan antara rasio neutrofil limfosit dan rasio platelet limfosit terhadap derajat aktifitas penyakit lupus pada pasien lupus eritematosus sistemik.Metode. Penelitian ini adalah penelitian analitik observasional dengan menggunakan data rekam medik pasien instalasi pusat di RSUP H.Adam Malik pada periode Januari 2019 sampai Desember 2019. Sampel dihitung menggunakan rumus besar sampel komparatif tidak berpasangan lebih dari dua kelompok satu kali pengukuran. Kemudian dilakukan uji distribusi dengan uji Shapiro Wilk. Analisis bivariat dilakukan untuk mengetahui hubungan antara rasio neutrofil limfosit dan rasio platelet limfosit dengan skor MEX SLEDAI menggunakan uji ANOVA jika data berdistribusi normal, atau uji Kruskal-Wallis jika data berdistribusi tidak normal. Kemudian dilanjutkan dengan uji post hoc Mann Whitney untuk melihat kelompok mana yang memiliki perbedaan. Besarnya penyimpangan yang diinginkan (α) adalah 0,05, signifikan secara statistik jika p<0,05. Hasil. 120 subjek mengikuti penelitian dan terdapat 33 orang (27,5%) mengalami lupus eritematosus sistemik derajat ringan, 47 orang (39,2%) derajat sedang, dan 40 orang (33,3%) derajat berat. Rasio neutrofil-limfosit berhubungan dengan derajat aktivitas lupus pada pasien lupus eritematosus sistemik (p=0.001) dan rasio platelet-limfosit berhubungan dengan derajat aktivitas lupus pada penyakit lupus eritematosus sistemik. Kesimpulan. Rasio neutrofil-limfosit dan rasio platelet limfosit berhubungan dengan derajat aktivitas lupus pada pasien lupus eritematosus sistemik.