Pengaruh Dabigatran Terhadap Prothrombin Time, Activated Partial Thromboplastin Time, Trombin Time dan Trombosit Pada Pasien Paska Stroke Iskemik Kardioemboli

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Pengaruh Dabigatran Terhadap Prothrombin Time, Activated Partial Thromboplastin Time, Trombin Time dan Trombosit pada Pasien Paska Stroke Iskemik Kardioemboli

E. Raskita

1

_{, H. Hariman}

1

_{, A. S. Rambe}

2

1

_{Departemen Patologi Klinik, Fakultas Kedokteran, Universitas Sumatera Utara,}

Medan,

2

_{Departemen Ilmu Penyakit Saraf, Fakultas Kedokteran Universitas Sumatera}

Utara, Medan

Latar Belakang

: S

troke merupakan penyakit yang meningkat prevalensinya seiring perubahan pola hidup di masyarakat. Stroke iskemik merupakan penyebab tertinggi (85%) dan seperempatnya akibat stroke tromboemboli. Anti koagulan Dabigatran sebagaiinhibitor factor II (thrombin) diduga mempengaruhi proses hemostasis baik Prothrombin Time,

activated Partial Thromboplastin TimedanThrombin Timedan Trombosit.

Tujuan Umum : Penelitian ini dilakukan untuk mengetahui efek dabigatran terhadap hasil tes PT, aPTT, TT dan trombosit pada penderita paska stroke kardioemboli.

Metoda dan cara:

Penelitian ini menggunakan metode eksperimental dengan kontrol, dilakukan di RSUP. H. Adam Malik Medan pada Januari – Maret 2014. Sampel penelitian 20 orang, dilakukan pemeriksaan Haemorrhagic screening test dan hitung trombosit sebelum dan 10 jam sesudah pemberian dabigatran 150 mg dengan perincian 10 orang sehat sebagai kontrol dan 10 orang post stroke iskemik sebagai subjek.

Hasil : Pada penelitian didapati mean sebelum dan sesudah pemberian Dabigatran pada kelompok subjek; PT (13,280±1,086) vs (13,390±0,867), p-value (0.008), INR (1,002±0,068) vs (1,057±0,057)p-value (0.001), aPTT (27,910 ± 9,486) vs (36,800 ± 7,853)p-value(0.045), TT (14,360 ± 1,591) vs (145,010 ± 47,692),p-value(0.001) dan Trombosit (287,000 ± 74,198) vs (285,700 ± 72,887), p-value (0.293). Tetapi tidak terdapat perbedaan antara kadar PT,aPTT, TT dan Trombosit antara kelompok kontrol dan subjek (p-value >0.05)

Kesimpulan: Terdapat perbedaan nilai PT dan aPTT, TT pada pemberian Dabigatran 150mg, namun tidak pada nilai Trombosit. Ternyata tidak ada perbedaaan nilai PT, aPTT, TT maupun Trombosit pada kelompok kontrol dan kelompok subjek sesudah pemberian Dabigatran.

Kata kunci: Dabigatran, PT (Prothrombin Time), aPTT (activated partial thromboplastin time) TT(Thrombin Time), Trombosit.

xiv

Effect of Dabigatran Against Prothrombin Time, Activated Partial Thromboplastin Time, Thrombin Time and Platelets in Patients with Ischemic Post Stroke Cardioembolism

E. Raskita

1

_{, H. Hariman}

1

_{, A. S. Rambe}

2

1_{Departement of clinical pathology, School of Medicine, Universitas Sumatera Utara/ H.}

Adam Malik Medan Hospital.

2_{Departement of Neurology, School of Medicine, Universitas Sumatera Utara/ H. Adam}

Malik Medan Hospital.

Background: Stroke is a disease that is increasing as changes in lifestyle in Indonesia. Ischemic stroke is the leading cause (85%) with a quarter because of a thromboembolic stroke. Dabigatran as factor II (thrombin) inhibitor suggest to influence the process in hemostasis ; Prothrombin time PT, activated Partial Thromboplastin Time APTT and Thrombin Time TT

Purpose: This study was conducted to determine the effect of dabigatran on the test results of PT, aPTT, TT and platelets in patients with post-stroke cardioembolism.

Methods: This experimental study using case control conducted in H. Adam Malik Hospital Medan from January-March 2014. Case and control group carried out Haemorrhagic screening test and platelet count before and 10 hours after administration of 150 mg dabigatran

Results: In this study, Mean values before and after administration of Dabigatran in the subjects group; PT (13,280±1,086) vs (13,390±0,867), p-value (0.008), INR (1,002±0,068) vs (1,057±0,057) p-value (0.001), aPTT (27.910 ± 9.486) vs (36.800 ± 7.853) p-value (0.045), TT (14,360 ± 1,591) vs (145,010 ± 47,692), p-value (0.001) and platelets (287.000 ± 74.198) vs. (285.700 ± 72.887), p-value (0.293). But there is no difference between the levels of PT, aPTT, TT and platelets between the control group and subjects (p-value> 0.05).

Conclusion: There are significant differences in PT, aPTT, and TT, but not in Platelets in subject group. There are no differences in the value of PT, aPTT, TT and platelets in the control group compare to subjects after administration of Dabigatran.

Keywords: Dabigatran, PT (Prothrombin Time), aPTT (activated partial thromboplastin time) TT (Thrombin Time), Platelets.