TERHADAP PENURUNAN KADAR IL-6 DAN HS-CRP PADA … · CERP = Cholesterol Efflux Regulatory Protein...
Transcript of TERHADAP PENURUNAN KADAR IL-6 DAN HS-CRP PADA … · CERP = Cholesterol Efflux Regulatory Protein...
KARYA TULIS AKHIR
PENGARUH PEMBERIAN EKSTRAK BIJI BUAH PINANG (Areca
Catechu L.) TERHADAP PENURUNAN KADAR IL-6 DAN HS-CRP PADA
TIKUS MODEL ATEROSKLEROTIK
Oleh:
MUHAMMAD PRIANGGA AKBAR
201110330311085
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH MALANG
2015
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HASIL PENELITIAN
PENGARUH PEMBERIAN EKSTRAK BIJI BUAH PINANG (Areca
Catechu L.) TERHADAP PENURUNAN KADAR IL-6 DAN HS-CRP PADA
TIKUS MODEL ATEROSKLEROTIK
Diajukan kepada
Universitas Muhammadiyah Malang
untuk Memenuhi Salah Satu Persyaratan
dalam Menyelesaikan Program Sarjana
Fakultas Kedokteran
Oleh :
Muhammad Priangga Akbar
201110330311085
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH MALANG
2015
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KATA PENGANTAR
Puji syukur penulis panjatkan kehadirat Allah SWT, karena atas rahmat dan
hidayah-Nya, penulis telah berhasil menyelesaikan Karya Tulis akhir ini yang
berjudul “Pengaruh Pemberian Ekstrak Biji Buah Pinang (Areca Catechu L.)
Terhadap Penurunan Kadar IL-6 dan HS-CRP Pada Tikus Model
Aterosklerotik”. Penulisan ini dilakukan dalam rangka memenuhi salah satu syarat
untuk mencapai gelar sarjana Kedokteran jurusan Pendidikan Dokter pada Fakultas
Kedokteran Universitas Muhammadiyah Malang.
Penulis menyadari bahwa penyusunan tugas akhir ini kemungkinan jauh
dari sempurna, walaupun demikian penulis telah berusaha semaksimal mungkin
serta mendapatkan bantuan dan bimbingan dari Dosen Pembimbing dalam rangka
penyusunan. Tanpa bantuan dan dorongan dari berbagai pihak, sangatlah tidak
mudah menjalani masa perkuliahan hingga pada penyusunan tugas akhir ini. Oleh
karena itu pada kesempatan ini penulis menyampaikan ucapan terima kasih kepada
:
1. Allah SWT, yang atas nikmat dan karunia-Nya lah penulis diberi
kesempatan menyelesaikan menyelesaikan studi kedokteran ini.
2. Rosulullah SAW, sebagai rosul seluruh ummat yang dengan kesabarannya
menyiarkan agama islam diseluruh muka bumi ini.
3. Orang tuaku tercinta, Bapak Dudi Supardi dan Ibu Imas Masriah serta Emak
Hj. Mimin Darmilah yang dengan kesabaran dan ketekunan dan doanya
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memberikan semangat pada penulis untuk menuntut ilmu di Fakultas
Kedokteran ini.
4. dr. Irma Suswati, M.Kes selaku Dekan Fakultas Kedokteran Universitas
Muahammadiyah Malang.
5. dr. Moch. Ma’roef, Sp.OG selaku Pembantu Dekan 1 Fakultas Kedokteran
Universitas Muhammadiyah Malang.
6. dr. Rahayu, Sp.S selaku Pembantu Dekan 2 Fakultas Kedokteran
Universitas Muhammadiyah Malang.
7. dr. Iwan Sys Indrawanto, Sp.KJ selaku Pembantu Dekan 3 Fakultas
Kedokteran Universitas Muhammadiyah Malang
8. dr. Meddy Setiawan, Sp.PD selaku Pembimbing I atas bimbingan,
pelajaran, dukungan, saran dan bantuan yang telah diberikan dalam
penyusunan karya tulis akhir ini.
9. dr. Anung Putri Ilahika selaku pembimbing II atas kesabaran dan
ketelitiannya dalam membimbing dan memberi saran dalam penyususnan
karya tulis akhir ini.
10. dr. Melany Farahdilla, Sp.A, M.Kes selaku penguji atas ketelitiannya dalam
memberi saran dan masukan dalam penyusunan karya tulis akhir ini.
11. Kakak-adikku tersayang Haifa Latifah dan Muhammad Hisyam Musyaffa
terima kasih atas bantuan doa dan semangatnya.
12. Yang terkasih Tanty Tunjung Sari terima kasih atas dorongan semangat dan
motivasi, dukungan, bantuan, serta doanya selama ini dan seterusnya.
13. Sahabat dan teman-teman terdekatku mokodo terima kasih atas semua
bantuannya, semoga kita semua bisa sukses dan menjadi dokter yang
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berguna dan bermanfaat bagi diri sendiri, kedua orangtua, keluarga, dan
masyarakat.
14. Seluruh Staff Fakultas Kedokteran terima kasih atas bantuan dan
kemudahan dalam urusan administrasi dan tugas akhir ini.
15. Teman-teman Fakultas Kedokteran Universitas Universitas
Muhammadiyah Malang angkatan 2011 yang menjadi teman seperjuangan
selama menempuh pendidikan ini.
16. Semua pihak yang turut membantu dalam menyelesaikan karya tulis ini juga
mendoakan demi suksesnya karya tulis ini yang tidak bisa penulis sebutkan
satu-persatu.
Akhir kata penulis berharap semoga penelitian ini dapat menambah
wawasan dan bermanfaat bagi semua pihak.
Malang, 25 Desember 2014
Penulis
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DAFTAR ISI
HALAMAN JUDUL ………………………………………………………...
LEMBAR PENGESAHAN ............................................................................
LEMBAR PENGUJIAN ................................................................................
KATA PENGANTAR ....................................................................................
ABSTRAK ......................................................................................................
ABSTRACT .....................................................................................................
DAFTAR ISI ………………………………………………………………..
DAFTAR SINGKATAN ...............................................................................
DAFTAR TABEL …………………………………………………………..
DAFTAR GAMBAR ……………………………………………………….
DAFTAR LAMPIRAN …………………………………………………….
BAB 1 PENDAHULUAN …………………………………………………..
1.1. Latar Belakang ……………………………………………….
1.2. Rumusan Masalah ……………………………………………
1.3. Tujuan Penelitian …………………………………………….
1.3.1. Tujuan umum ………………………………………...
1.3.2. Tujuan khusus ………………………………………..
1.4. Manfaat Penelitian …………………………………………...
1.4.1. Bagi akademis ………………………………..………
1.4.2. Bagi masyarakat ……………………………………...
1.4.3. Bagi klinisi……………………………………………
BAB 2 TINJAUAN PUSTAKA …………………………………..……….
2.1 Aterosklerosis ……….........………………………………….
2.1.1 Definisi aterosklerosis …........………………………..
2.1.2 Etiologi aterosklerosis ...………………………………
2.1.3 Faktor resiko aterosklerosis .………………..…………
2.1.4 Patogenesis aterosklerosis ............................................
2.1.5 Klasifikasi lesi aterosklerosis………………..………...
2.1.6 Proses inflamasi pada aterosklerosis…………………..
2.1.7 Peran makrofag dan pembentukan foam cell………….
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2.1.8 Peran sitokin (IL-6, HS-CRP) pada aterosklerosis…….
2.2 Tanaman Pinang ……………………………………………....
2.2.1 Taksonomi ...................................................................
2.2.2 Morfologi tanaman pinang ...........................................
2.2.3 Kandungan kimia tanaman pinang……………………
2.2.4 Proantosianidin……………………………………….
2.2.5 Proantosianidin debagai antioksidan…………………
2.2.6 Proantosianidin sebagai antiinflamasi………………..
BAB 3 KERANGKA KONSEPTUAL DAN HIPOTESIS PENELITIAN
3.1 Kerangka Konsep …………………..............………………...
3.2 Hipotesis Penelitian …………………………………………..
BAB 4 METODE PENELITIAN …...……………………………………..
4.1 Rancangan Penelitian ……………………….…………..…….
4.2 Tempat dan Waktu Penelitian ………………………………...
4.3 Populasi dan Sampel ………………………………………….
4.3.1 Populasi ……………………………………………….
4.3.2 Sampel ……………………………………………......
4.3.3 Estimasi besar sampel ………………………………...
4.3.4 Karakteristik sampel penelitian ……………………….
4.3.4.1 Kriteria inklusi ………………………………….
4.3.4.2 Kriteria eksklusi ……………….…………...…...
4.4 Bahan dan Alat Penelitian ……………………………...……..
4.4.1 Bahan…………………………………………………..
4.4.2 Alat…………………………………………………….
4.5 Variabel dan Definisi Operasional…………………………….
4.5.1 Variabel bebas ………………………………………...
4.5.2 Variabel tergantung …………………………………...
4.5.3 Definisi operasional …………………………………..
4.6 Dasar Penentuan Dosis Ekstrak Biji Buah Pinang…………….
4.7 Alur Penelitian ………………………………………………...
4.8 Prosedur Penelitian …………………………………...……….
4.8.1 Pembagian kelompok tikus …………………...………
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4.8.2 Adaptasi………………………………………………..
4.8.3 Pemberian diet aterogenik……………………………..
4.8.4 Pembuatan ekstrak biji buah pinang…………………..
4.8.5 Proses anastesi dan pembedahan serta pengambilan
serum tikus…………………………………………….
4.8.6 Pemeriksaan kadar IL-6 dan HS-CRP…………………
4.9 Analisis Data ………………...………………………….…….
BAB 5 HASIL PENELITIAN DAN ANALISIS DATA ..............................
5.1 Hasil Pemeriksaan dan Analisis Data Kadar IL-6 .....................
5.2 Hasil Pemeriksaan dan Analisis Data Kadar HS-CRP ………..
BAB 6 PEMBAHASAN...................................................................................
BAB 7 KESIMPULAN DAN SARAN ...........................................................
7.1 Kesimpulan ……………………………………………………
7.2 Saran …………………………………………… …………….
DAFTAR PUSTAKA ………………………………………………………..
LAMPIRAN………………………………………………………………….
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DAFTAR SINGKATAN
AHA = America Heart Association
ANOVA = Analysis of Varians
CERP = Cholesterol Efflux Regulatory Protein
ELISA = Enzyme Linked Immunosorbent Assay
HDL = High Density Lipoprotein
HS-CRP = High Sensitivity C-Reactive Protein
HSP = Heat Shock Protein
ICAM = Intracellular Cell Adhesion Molecule
IFN-y = Interferon-Gamma
IL-1 = Interleukin-1
IL-6 = Interleukin-6
LDL = Low Density Lipoprotein / Lipoprotein Berdensitas Rendah
MCP = Monocyte Chemoattractant Protein
M-CSF = Macrophage Colony Stimulating Factor
NF-kB = Nuclear Factor-Kappa B
NO = Nitric Oxide
OPCs = Oligometric Proantocyanidin
Ox-LDL = Lipoprotein Berdensitas Rendah – Teroksidasi
PKC = Protein Kinase C
ROS = Reactive Oxygen Species
TGF-b = Transforming Growth Factor-Beta
TLR = Toll Like Receptor
TNF-a = Tumor Necrosis Factor-Alpha
VCAM = Vascular Cell Adhesion Molecule
VLDL = Very Low Density Lipoprotein
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DAFTAR TABEL
Tabel Halaman
Tabel 5.1. Rata-rata ketebalan tunika media dan intima……... 41
Tabel 5.2 Rata-rata Kadar IL-6……..………………………. 41
Tabel 5.3 Rata-rata Kadar HS-CRP…..…………………….. 44
‘
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DAFTAR GAMBAR
Gambar Halaman
Gambar 2.1 Peran LDL dalam patogenesis aterosklerosis……… 5
Gambar 2.2 Patogenesis terjadinya aterosklerosis……………… 9
Gambar 2.3 Hubungan beberapa sitokin dalam patogenesis
aterosklerosis…………………………………...….
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Gambar 2.4 Buah Pinang……………………………………….. 17
Gambar 5.1. Diagram batang rata-rata kadar IL-6….……….…... 42
Gambar 5.2 Grafik uji regresi pengaruh dosis ekstrak biji buah
pinang terhadap kadar IL-6…….…………………..
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Gambar 5.3 Diagram batang rata-rata kadar HS-CRP.……….… 44
Gambar 5.4 Grafik uji regresi pengaruh dosis ekstrak biji buah
pinang terhadap kadar HS-CRP…………………..
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Gambar 6.1 Berbagai factor pencetus ekspresi HSP………….. 56
Gambar 6.2 Jalur sinyal transduksi HSP terhadap beberapa tipe
sel……….……....
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DAFTAR LAMPIRAN
Lampiran Halaman
Lampiran 1 Analisis Data……………………………................. 65
Lampiran 2 Surat Keterangan Determinasi................................... 71
Lampiran 3 Lembar Konsultasi Tugas Akhir............................... 72
Lampiran 4 Dokumentasi Penelitian……………………….…… 73
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