Hubungan Lipid Profile Dan Left Ventricular Mass Index ( LVMI ) Pada Pasien Pgk Dengan Hemodialisis

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Lampiran 2

LEMBAR PENJELASAN KEPADA CALON SUBJEK PENELITIAN

Selamat pagi/siang Bapak/Ibu, pada hari ini saya, dr.Silvia Bukit ,peserta Pendidikan Pasca Sarjana Ilmu Penyakit Dalam / Magister Klinik FK USU Medan akan melakukan penelitian yang berjudul ”Hubungan Lipid Profile dan Left Ventricular Mass Index (LVMI) pada pasien PGK dengan hemodialisis”.

Kepada Bapak/Ibu yang bersedia mengikuti penelitian ini nantinya akan diminta mengisi surat persetujuan ikut dalam penelitian, mengikuti wawancara untuk mencari adanya hal-hal yang dapat mengganggu penelitian, dilakukan pemeriksaan laboratorium berupa pemeriksaan darah sebanyak 10 cc (1 sendok makan) yang akan diambil dari lengan oleh ahlinya untuk menilai kadar lipid, darah rutin dan faal ginjal, dan kemudian akan dilakukan pemeriksaan ekokardiografi untuk menilai apakah sudah terdapat pembesaran ventrikel kiri.

Manfaat penelitian ini adalah untuk mengetahui adanya hubungan dislipidemia dengan terjadinya pembesaran ventrikel kiri jantung pada pasien penyakit ginjal kronik yang menjalani hemodialisis sehingga dapat mendeteksi dini pembesaran ventrikel kiri untuk mencegah komplikasi kardiovaskular yang serius.

Pada penelitian ini tidak menimbulkan efek samping apapun namun risiko yang dapat terjadi dari penelitian ini adalah munculnya lebam setelah pengambilan darah, yang dapat hilang dengan sendirinya setelah beberapa hari .

Setelah hasil akhir diperoleh, nantinya akan terlihat apakah terdapat hubungan antara dislipidemia dengan hipertrofi ventrikel kiri jantung pada penderita penyakit ginjal kronis dengan hemodialisis. Bila masih terdapat pertanyaan atau keluhan sewaktu penelitian ini berjalan, maka Bapak/Ibu dapat menghubungi saya pada:

Nama : dr. Silvia Bukit

Alamat : Jl. Komando no 30 Pematang Siantar

Telepon : 081361226201

Peneliti,

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Lampiran 3

SURAT PERSETUJUAN SETELAH PENJELASAN (INFORMED CONSENT )

Saya yang bertanda tangan dibawah ini :

Nama :... Alamat :... Umur :... Tahun

Jenis Kelamin : Laki-laki/ Perempuan. No Telp/HP :

Setelah mendapat penjelasan dari peneliti tentang kebaikan dan keburukan prosedur penelitian ini , menyatakan bersedia

Demikianlah surat persetujuan bersedia ikut dalam penelitian ini saya buat, untuk dapat digunakan seperlunya.

ikut serta dalam penelitian tentang ” Hubungan Lipid Profile dan Left Ventricular Mass Index (LVMI) pada pasien PGK dengan Hemodialisis”. Apabila sewaktu-waktu saya mengundurkan diri dari penelitian ini, kepada saya tidak dituntut apapun.

Medan,...2014

Saksi Yang Memberi Pernyataan

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Lampiran 4

KERTAS KERJA PROFIL PESERTA PENELITIAN

I.IDENTITAS PRIBADI

Nama : Kode : X / Y

Usia :

Jenis Kelamin : Laki-laki/Perempuan. Pendidikan Terakhir :

Pekerjaan :

Status : Kawin/Belum Kawin. No Telp/Hp:...

Riwayat Penyakit (Penyebab PGK) : DM / GNC / PGOI / Kista

Ginjal/UAN

Saat mulai menjalani Hemodialisis (durasi) :

Riwayat pemakaian obat :

II.PEMERIKSAAN FISIK

TDS/ TDD : ... mmHg

Berat badan : ... kg

Tinggi Badan : ... cm

III.PEMERIKSAAN LABORATORIUM

Parameter Nilai

Hb Ureum Creatinin

Kolesterol Total Trigliserida HDL LDL

Hasil Ekokardiografi :

Parameter Nilai

IVSD LVEDD LVPWD LV mass

BSA (Body Surface Area) :

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LAMPIRAN 5

DAFTAR RIWAYAT HIDUP

I. Identitas Pribadi

Nama : dr.Silvia Bukit

Tempat/Tgl Lahir : Pematang Siantar/ 21 Januari 1983

Suku/Bangsa : Karo / Indonesia

Agama : Kristen

Alamat : Jl. Komando no.30 Pematang Siantar

II. Pendidikan

SDN 122401 Pematangsiantar Tamat Tahun 1994

SLTPN 2 Pematangsiantar Tamat Tahun 1997 SMAN 2 Pematangsiantar Tamat Tahun 2000 Fakultas Kedokteran Universitas Sumatera Utara Tamat Tahun 2006

III.Riwayat Pekerjaan

Pasca PTT Kabupaten Muko-muko Bengkulu Utara

IV.Perkumpulan Profesi

IDI Medan

PAPDI Sumatera Utara

V. Journal Reading:

1. Matsumoto H, Miyaoka Y, Okada T, et al. Ratio of Urinary Potassium to Urinary Sodium and the Potassium and edema status in Nephrotic Syndrome. Intern Med 2011.

2. Kanodia KV, Shah PR, Vanikar AV, et al. Malaria Induced Acute Renal Failure; a single centre experience. Saudi J Kidney Dis Transpl 2010.

3. Hassan SB, El-demery AB, Ahmed AI, et al. Soluble Tweak & Cardiovascular Morbidity and Mortality in CKD patients. Arab Journal of Nephrology and Transplantation 2012.

4. Binbrek AS, Rao NS, van WF, et al. Meta-Analysis of Patients in the United Arab Emirates with ST-Elevation Myocardial Infarction Treated with Thrombolytic agents. Am J Kardiol 2010.

5. Saaristo T, Moilanen L, Korpi E et al. Lifestyle Intervention for Prevention of Type 2 Diabetes in Primary Health Care. Diabetes Care 2010.

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7. Tateishi Y, Kouyama R, Mihara M, et al. Evaluation of Salivary Cortisol Measurement for the Diagnosis of Subclinical Cushings Syndrome. Endocrine Journal 2012.

8. Yang Y, Feng X, Li-yun S, et al. Efficacy and Significance of Various Score for Pneumonia Severity in the Management of Patients with CAP in China. Chinese Medical Journal 2012.

9. Brassard P, Suissa S, Kezouh A, et al. Inhaled Corticosteroids and Risk of Tuberculosis in Patients with Respiratory Diseases. Am J Respir Crit Care Med 2011.

10. Wechsler ME, Kelley JM, Boyd IOE, et al. Active Albuterol or Placebo, Sham Acupunctur or No Intervention in Asthma. N Engl J Med 2011.

11. Khosravi AD, Alavi SM, Hashemzade M, et al. The Relative

Frequency of Mycobacterium tuberculosis and Mycobacterium avium infections in HIV positive patients, Ahvaz, Iran. Asian Pacific Journal of Tropical Medicine 2012.

12. Desakorn V, Wuthiekanum V, Thanachartwet V, et al. Accuracy of a Commercial Ig M ELISA for the Diagnosis of Human Leptospirosis in Thailand. Am. J. Trop. Med. Hyg. 2012.

13. Patrella RJ, Decaria J, Patrella RJ. Longterm Efficacy & Safety of a Combined Low and High Molecular Weight Hyaluronic acid in the treatment of osteoarthritis of the knee. Rheumatology Reports 2011.

14. Agnelli G, Buller HR, Cohen A, et al. Apixaban for Extended

Treatment of Venous Thromboembolism. N Engl J Med 2012

15. Bensouda LG, Michel M, Aubrun E, et al. A Case-Control Study to Assess the risk of Immune Thrombocytopenia Associated with Vaccines. The American Society of Hematology 2012.

VI.Tulisan Ilmiah

1. Kanker kolorektal 2. Malaria Nefropati

3. Congestive Heart Failure 4. Leptin Pada Kardiovaskular 5. Hipertensi Pulmonal Pada COPD 6. Rubella

7. Thalassemia

VII. Publikasi Ilmiah

1. Bukit S, Lubis AR, Bustami Z, Nasution SR, Lubis HR. Penyakit Ginjal Polikistik Dominan Autosomal : Laporan Kasus. PERNEFRI ,Bali, 2012.

2. Bukit S, Dairi LB. Tuberkulosis Pankreas: Laporan Kasus.

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Lampiran 6

HASIL STATISTIK

One-Sample Kolmogorov-Smirnov Test

55 48.45 12.761 .099 .052 -.099 .733 .655 55 42.96 36.442 .212 .212 -.149 1.573 .014 55 140.36 13.873 .154 .154 -.120 1.144 .146 55 84.91 8.361 .256 .194 -.256 1.898 .001 55 54.97 6.864 .095 .095 -.089 .705 .703 55 160.55 7.180 .151 .126 -.151 1.118 .164 55 9.945 1.7861 .096 .096 -.061 .713 .690 55 125.89 57.573 .140 .140 -.079 1.039 .231 55 10.6687 4.36800 .103 .103 -.080 .763 .605 55 7.5422 3.07084 .129 .129 -.086 .956 .321 55 175.09 43.438 .112 .112 -.058 .832 .493 55 160.31 91.119 .143 .143 -.106 1.062 .209 55 35.84 9.496 .101 .101 -.073 .747 .631 55 114.20 60.382 .209 .209 -.113 1.547 .017 55 12.547 3.3337 .146 .146 -.072 1.086 .189 55 49.805 7.4299 .053 .046 -.053 .390 .998 55 12.445 4.7735 .227 .227 -.142 1.683 .007 55 258.29293 127.400358 .155 .155 -.121 1.148 .144 55 1.56264 .115085 .087 .051 -.087 .648 .796 55 166.36851 88.793553 .180 .180 -.145 1.334 .057 Umur (tahun)

Lama HD TDS TDD BB TB Hb Ureum Creatinin Cr Cl Koleterol total Trigliserida HDL LDL IVSD LVEDD LVPWD LV Mass BSA LVMI

N Mean Std. Deviation Normal Parametersa,b

Absolute Positive Negative Most Extreme Differences

Kolmogorov-Smirnov Z Asymp. Sig. (2-tailed)

Test distribution is Normal. a.

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Correlations

1 -.106 .146 .389** .427** -.129 -.207 -.256 .243 -.155

.442 .287 .003 .001 .348 .130 .059 .073 .259

55 55 55 55 55 55 55 55 55 55

-.106 1 -.161 -.306* -.215 .126 -.032 .030 -.071 -.281*

.442 .239 .023 .115 .358 .816 .830 .607 .037

55 55 55 55 55 55 55 55 55 55

.146 -.161 1 .203 .088 .032 -.054 -.072 -.259 -.139

.287 .239 .137 .524 .819 .696 .604 .056 .311

55 55 55 55 55 55 55 55 55 55

.389** -.306* .203 1 .656** .050 -.048 .194 -.126 -.043

.003 .023 .137 .000 .716 .728 .155 .359 .758

55 55 55 55 55 55 55 55 55 55

.427** -.215 .088 .656** 1 .072 -.149 -.161 .222 .135

.001 .115 .524 .000 .603 .279 .240 .104 .327

55 55 55 55 55 55 55 55 55 55

-.129 .126 .032 .050 .072 1 .360** -.069 .104 .138

.348 .358 .819 .716 .603 .007 .616 .450 .314

55 55 55 55 55 55 55 55 55 55

-.207 -.032 -.054 -.048 -.149 .360** 1 -.023 -.090 .035

.130 .816 .696 .728 .279 .007 .868 .515 .801

55 55 55 55 55 55 55 55 55 55

-.256 .030 -.072 .194 -.161 -.069 -.023 1 -.264 -.281*

.059 .830 .604 .155 .240 .616 .868 .052 .038

55 55 55 55 55 55 55 55 55 55

.243 -.071 -.259 -.126 .222 .104 -.090 -.264 1 .507**

.073 .607 .056 .359 .104 .450 .515 .052 .000

55 55 55 55 55 55 55 55 55 55

-.155 -.281* -.139 -.043 .135 .138 .035 -.281* .507** 1

.259 .037 .311 .758 .327 .314 .801 .038 .000

55 55 55 55 55 55 55 55 55 55

LVMI Umur (tahun) Lama HD TDS TDD BB TB Hb Ureum Creatinin

Correlation is significant at the 0.01 level (2-tailed). **.

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Correlations

1.000 -.182 .364** .553** .542** -.069 -.039 -.178 .137 -.145 . .183 .006 .000 .000 .617 .778 .195 .318 .291 55 55 55 55 55 55 55 55 55 55 -.182 1.000 -.094 -.308* -.221 .071 -.033 .068 -.053 -.230 .183 . .497 .022 .105 .606 .811 .623 .700 .091 55 55 55 55 55 55 55 55 55 55 .364** -.094 1.000 .302* .139 .099 -.046 -.055 -.190 -.030 .006 .497 . .025 .312 .472 .737 .692 .165 .826 55 55 55 55 55 55 55 55 55 55 .553** -.308* .302* 1.000 .680** .100 .017 .148 -.090 -.072 .000 .022 .025 . .000 .469 .903 .279 .515 .604 55 55 55 55 55 55 55 55 55 55 .542** -.221 .139 .680** 1.000 .064 -.124 -.109 .236 .084 .000 .105 .312 .000 . .643 .368 .429 .082 .541 55 55 55 55 55 55 55 55 55 55 -.069 .071 .099 .100 .064 1.000 .306* -.003 .080 .123 .617 .606 .472 .469 .643 . .023 .984 .563 .370 55 55 55 55 55 55 55 55 55 55 -.039 -.033 -.046 .017 -.124 .306* 1.000 -.070 -.160 .077 .778 .811 .737 .903 .368 .023 . .610 .243 .576 55 55 55 55 55 55 55 55 55 55 -.178 .068 -.055 .148 -.109 -.003 -.070 1.000 -.268* -.321*

.195 .623 .692 .279 .429 .984 .610 . .048 .017 55 55 55 55 55 55 55 55 55 55 .137 -.053 -.190 -.090 .236 .080 -.160 -.268* 1.000 .469** .318 .700 .165 .515 .082 .563 .243 .048 . .000

55 55 55 55 55 55 55 55 55 55 -.145 -.230 -.030 -.072 .084 .123 .077 -.321* .469** 1.000 .291 .091 .826 .604 .541 .370 .576 .017 .000 .

LVMI Umur (tahun) Lama HD TDS TDD BB TB Hb Ureum Creatinin

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Correlations

1 .135 -.072 .232 -.507** -.050 .546** .344* .854** .989** -.168 .325 .600 .088 .000 .718 .000 .010 .000 .000 .221

55 55 55 55 55 55 55 55 55 55 55

.135 1 .326* .160 -.311* .292* -.016 .224 .066 .156 .123 .325 .015 .243 .021 .031 .909 .100 .630 .256 .370

55 55 55 55 55 55 55 55 55 55 55

-.072 .326* 1 .387** -.037 .641** -.084 -.084 -.002 -.074 .013 .600 .015 .003 .789 .000 .544 .544 .989 .591 .926

55 55 55 55 55 55 55 55 55 55 55

.232 .160 .387** 1 -.258 .589** .142 .107 .179 .207 -.227 .088 .243 .003 .058 .000 .302 .436 .192 .130 .096

55 55 55 55 55 55 55 55 55 55 55

-.507** -.311* -.037 -.258 1 -.117 -.272* -.497** -.325* -.529** -.001 .000 .021 .789 .058 .394 .044 .000 .016 .000 .992

55 55 55 55 55 55 55 55 55 55 55

-.050 .292* .641** .589** -.117 1 -.054 .004 -.031 -.055 -.047 .718 .031 .000 .000 .394 .696 .976 .823 .688 .735

55 55 55 55 55 55 55 55 55 55 55

.546** -.016 -.084 .142 -.272* -.054 1 -.081 .371** .589** .138 .000 .909 .544 .302 .044 .696 .557 .005 .000 .315

55 55 55 55 55 55 55 55 55 55 55

.344* .224 -.084 .107 -.497** .004 -.081 1 -.012 .369** .051 .010 .100 .544 .436 .000 .976 .557 .933 .005 .711

55 55 55 55 55 55 55 55 55 55 55

.854** .066 -.002 .179 -.325* -.031 .371** -.012 1 .845** -.054 .000 .630 .989 .192 .016 .823 .005 .933 .000 .697

55 55 55 55 55 55 55 55 55 55 55

.989** .156 -.074 .207 -.529** -.055 .589** .369** .845** 1 -.033 .000 .256 .591 .130 .000 .688 .000 .005 .000 .811

55 55 55 55 55 55 55 55 55 55 55

-.168 .123 .013 -.227 -.001 -.047 .138 .051 -.054 -.033 1 .221 .370 .926 .096 .992 .735 .315 .711 .697 .811

55 55 55 55 55 55 55 55 55 55 55

LVMI Cr Cl Koleterol total Trigliserida HDL LDL IVSD LVEDD LVPWD LV Mass BSA

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Correlations

1.000 .194 -.083 .365** -.746** -.011 .537** .567** .643** .961** -.064 . .155 .548 .006 .000 .937 .000 .000 .000 .000 .643

55 55 55 55 55 55 55 55 55 55 55

.194 1.000 .322* .268* -.245 .308* -.013 .225 .032 .174 .127

.155 . .017 .048 .071 .022 .927 .098 .816 .203 .356

55 55 55 55 55 55 55 55 55 55 55

-.083 .322* 1.000 .456** .075 .820** -.111 -.086 -.007 -.146 -.004

.548 .017 . .000 .587 .000 .420 .530 .962 .287 .978

55 55 55 55 55 55 55 55 55 55 55

.365** .268* .456** 1.000 -.349** .287* .189 .111 .324* .291* -.207

.006 .048 .000 . .009 .034 .168 .421 .016 .031 .130

55 55 55 55 55 55 55 55 55 55 55

-.746** -.245 .075 -.349** 1.000 -.089 -.407** -.448** -.467** -.737** .012

.000 .071 .587 .009 . .520 .002 .001 .000 .000 .933

55 55 55 55 55 55 55 55 55 55 55

-.011 .308* .820** .287* -.089 1.000 -.107 -.022 -.016 -.095 -.010

.937 .022 .000 .034 .520 . .437 .871 .910 .490 .943

55 55 55 55 55 55 55 55 55 55 55

.537** -.013 -.111 .189 -.407** -.107 1.000 -.160 .653** .594** .188

.000 .927 .420 .168 .002 .437 . .244 .000 .000 .170

55 55 55 55 55 55 55 55 55 55 55

.567** .225 -.086 .111 -.448** -.022 -.160 1.000 -.044 .529** -.010

.000 .098 .530 .421 .001 .871 .244 . .752 .000 .943

55 55 55 55 55 55 55 55 55 55 55

.643** .032 -.007 .324* -.467** -.016 .653** -.044 1.000 .705** .210

.000 .816 .962 .016 .000 .910 .000 .752 . .000 .123

55 55 55 55 55 55 55 55 55 55 55

.961** .174 -.146 .291* -.737** -.095 .594** .529** .705** 1.000 .133

.000 .203 .287 .031 .000 .490 .000 .000 .000 . .334

55 55 55 55 55 55 55 55 55 55 55

-.064 .127 -.004 -.207 .012 -.010 .188 -.010 .210 .133 1.000

.643 .356 .978 .130 .933 .943 .170 .943 .123 .334 .

LVMI Cr Cl Koleterol total Trigliserida HDL LDL IVSD LVEDD LVPWD LV Mass BSA

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Descriptives

Interval for Mean

5% Trim med Mean Median

Variance Std. Deviati on Mi nimum

Interval for Mean

5% Trim med Mean Median

Variance Std. Deviati on Mi nimum Jenis kelam in

Pria

Wanita LVMI

Statisti c Std. Error

Tests of Normality

.111 27 .200* .959 27 .358

Statistic df Sig. Statistic df Sig. Kolmogorov-Smirnova Shapiro-Wilk

This is a lower bound of the true s ignificance. *.

Lilliefors Significance Correction a.

T-Test

Group Statistics

27 155.86296 53.381631 10.273300 28 176.49886 113.171291 21.387364 Jenis kelamin

Pria Wanita LVMI

N Mean Std. Deviation

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Independent Samples Test

1.201 .278 -.860 53 .394 -20.635894 24.007930 -68.7897 27.517915

-.870 38.754 .390 -20.635894 23.726778 -68.6376 27.365773 Equal variances

assumed Equal variances not assumed LVMI

F Sig. Levene's Test for Equality of Variances

t df Sig. (2-tailed) Mean Difference

Std. Error

Difference Lower Upper 95% Confidence

Interval of the Difference t-test for Equality of Means

NPar Tests

Mann-Whitney Test

Ranks

27 27.81 751.00

28 28.18 789.00

55 Jenis kelamin

Pria Wanita Total LVMI

N Mean Rank Sum of Ranks

Test Statisticsa

373.000 751.000 -.084 .933 Mann-Whitney U

Wilcoxon W Z

As ymp. Sig. (2-tailed)

LVMI

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Explore

Riwayat penyakit PGK

Descriptives

Interval for Mean

5% Trimmed Mean Median

Interval for Mean

5% Trimmed Mean Median Riwayat penyakit PGK

DM

NON DM LVMI

Statistic Std. Error

.315 21 .000 .638 21 .000

.092 34 .200* .969 34 .444

Riwayat penyakit PGK DM

NON DM LVMI

Statistic df Sig. Statistic df Sig.

Kolmogorov-Smirnova Shapiro-Wilk

This is a lower bound of the true significance. *.

T-Test

21 186.00862 128.771251 28.100191

34 154.23785 49.545702 8.497018

NON DM LVMI

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4.973 .030 1.297 53 .200 31.770766 24.489750 -17.3495 80.890984

1.082 23.705 .290 31.770766 29.356771 -28.8586 92.400157 Equal variances

Std. Error

NPar Tests

Mann-Whitney Test

Ranks

21 27.86 585.00 34 28.09 955.00 55

NON DM Total LVMI

354.000 585.000 -.052 .959 Mann-Whitney U

Wi lcoxon W Z

LVMI

Groupi ng Variable: Riwayat penyakit PGK a.

Explore

Ace inh/ARB

Case Processing Summary

38 100.0% 0 .0% 38 100.0%

17 100.0% 0 .0% 17 100.0%

Ace inh/ARB Makan obat Tidak makan obat LVMI

N Percent N Percent N Percent

Valid Missing Total

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Descriptives

Interval for Mean

Tidak makan obat LVMI

Statistic Std. Error

.105 38 .200* .968 38 .345

.359 17 .000 .624 17 .000

Ace inh/ARB Makan obat Tidak makan obat LVMI

Statistic df Sig. Statistic df Sig.

Kolmogorov-Smirnova Shapiro-Wilk

This is a lower bound of the true significance. *.

T-TEST

T-Test

38 129.78768 31.856253 5.167767 17 248.13741 118.239429 28.677274 Ace inh/ARB

Makan obat Tidak makan obat LVMI

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8.729 .005 -5.777 53 .000 -118.3497 20.485417 -159.438 -77.2612 -4.062 17.048 .001 -118.3497 29.139181 -179.815 -56.8847 Equal variances

Std. Error

NPar Tests

Mann-Whitney Test

Ranks

38 19.95 758.00 17 46.00 782.00 55

Ace inh/ARB Makan obat Tidak makan obat Total

LVMI

17.000 758.000 -5.573 .000 Mann-Whitney U

Wilcoxon W Z

LVMI

Grouping Variable: Ace inh/ARB a.

Frequency Table

Jenis kelamin

27 49.1 49.1 49.1

28 50.9 50.9 100.0 55 100.0 100.0

Pria Wanita Total Valid

Frequency Percent Valid Percent

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Riwayat penyakit PGK

55 100.0 100.0

GNC

Cumulative Percent

Riwayat penyakit PGK

21 38.2 38.2 38.2

34 61.8 61.8 100.0 55 100.0 100.0

DM Non DM Total Valid

Cumulative Percent

Ace inh/ARB

38 69.1 69.1 69.1

17 30.9 30.9 100.0 55 100.0 100.0

Makan obat Tidak makan obat Total

Valid

Cumulative Percent

CCB

22 40.0 40.0 40.0

33 60.0 60.0 100.0 55 100.0 100.0

Valid

Cumulative Percent

Diuretik

15 27.3 27.3 27.3

40 72.7 72.7 100.0 55 100.0 100.0

Valid

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LVMI 600.000 400.000 200.000 0.000

TDS150160170

140

130

120

110

LVMI

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100

95

90

85

80

75

70

LVMI

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