HUBUNGAN ANTARA PUMA SKOR UNTUK MENDETEKSI PENYAKIT PARU OBSTRUKTIF KRONIS (PPOK) DENGAN KADAR NEUTROPHIL LYMPHOCYTE RATIO (NLR) DI RSUD WALED
Keywords:
NLRAbstract
LATAR BELAKANG: Penyakit Paru Obstruktif Kronis (PPOK) masih menjadi suatu penyakit yang mengancam bagi seluruh masyarakat di Indonesia maupun di dunia. PPOK masih menjadi salah satu penyebab kematian tertinggi di Indonesia dengan menempati peringkat tiga, terdapat kuesioner untuk mendeteksi PPOK yang dapat digunakan sebagai skrining awal PPOK yakni PUMA skor. NLR merupakan marker inflamasi yang akan meningkat pada penyakit kronis salah satunya pada PPOK. METODE: Penelitian ini merupakan penelitian observasional analitik dengan menggunakan desain penelitian cross sectional. Sampel yang digunakan dalam penelitian ini sebanyak 30 responden. Teknik sampling yang digunakan adalah non-probability sampling melalui pendekatan consecutive sampling. Uji statistik yang digunakan menggunakan uji korelasi rank spearman. HASIL: Hasil deteksi PPOK menggunakan kuesioner skrining PUMA di RSUD Waled, dari 30 responden, sebanyak 23 responden (77 %) memperoleh hasil skor kuesioner skrining PUMA ≥ 6. Terdapat hubungan yang signifikan (p < 0,05) antara kuesioner skrining PUMA untuk mendeteksi PPOK dengan kadar marker inflamasi NLR (p = 0,0001) di RSUD Waled dengan kekuatan korelasi kuat dan arah korelasi positif (r = 0,671). SIMPULAN: Terdapat hubungan yang signifikan (p < 0,05) antara kuesioner skrining PUMA untuk mendeteksi PPOK dengan kadar marker inflamasi NLR (p = 0,0001) di RSUD Waled dengan korelasi kuat dan arah korelasi positif (r = 0,671), yang memiliki makna apabila hasil score kuesioner skrining PUMA ≥ 6 maka semakin meningkat kadar NLR.
Kata kunci: NLR, PPOK, kuesioner skrining PUMA
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is still a disease that threatens all people in Indonesia and in the world. COPD is still one of the highest causes of death in Indonesia, ranking three, there is a questionnaire to detect COPD that can be used as an initial screening for COPD that is the PUMA score. NLR is an inflammatory marker that will increase in chronic diseases, one of which is COPD. METHODS: This research is an analytic observational study with using a cross sectional research design. The sample used in this study were 30 respondents. The sampling technique used is non-probability sampling through a consecutive sampling approach. The statistical test used was Rank Spearman's correlation test. RESULTS: The results of COPD detection using the PUMA screening questionnaire at Waled Hospital, out of 30 respondents, as many as 23 respondent (77%) obtained the results of the PUMA screening questionnaire score ≥ 6. There is a significant relationship (p<0.05) between the PUMA screening questionnaire for COPD detection and the levels of the inflammatory marker NLR (p = 0,001) at Waled Hospital with a high correlation and a positive direction of correlation (r = 0,671) CONCLUSION: There is a significant relationship (p <0.05) between the PUMA screening questionnaire for COPD detection and the levels of the inflammatory marker NLR (p = 0,001) in Waled Hospital with a high correlation and a positive correlation (r = 0.671) which has meaning if the results of the PUMA screening questionnaire score ≥ 6, the NLR level increases
References
1. Varela MVL, de Oca MM, Wehrmeister FC, Rodriguez C, Ramirez L, Menezes A. External validation of the PUMA COPD diagnostic questionnaire in a general practice sample and the PLATINO study population. International Journal of COPD. 2019; 14: 1901-11.
2. Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2023. Available from: https://goldcopd.org/
3. Adi PR. Ilmu Penyakit Dalam. 6th ed. Interna Publishing; 2017.
4. Yip KP, Stockley RA, Sapey E. Catching “early” copd-the diagnostic conundrum. Vol. 16, International Journal of COPD. Dove Medical Press Ltd; 2021. p. 957–68.
5. Depkes RI. Pedoman Pengendalian Penyakit Paru Obstruktif Kronik Menteri Kesehatan Republik Indonesia. 2019. Available from: https://persi.or.id/wp-content/uploads/2020/11/kmk10222008.pdf
6. Au-Doung PLW, Wong CKM, Chan DCC, Chung JWH, Wong SYS, Leung MKW. PUMA screening tool to detect COPD in high-risk patients in Chinese primary care- A validation study. Plos One. 2022 Sep 1; 17 (9 September).
7. Guyton and Hall Textbook of Medical Physiology [Internet]. Available from: http://avaxho.me/blogs/ChrisRedfield
8. Syahrizal D, Andayani N, Aprilianti R. Gambaran hasil spirometri pada wanita pedesaan Krueng Raya. Jurnal Kedokteran Syiah Kuala. 2020 Aug 1;20(2).
9. Prihantini NN, Batubara FR. Faktor-Faktor yang Mempengaruhi Fungsi Paru Pada Mahasiswa FK UKI Melalui Pemeriksaan Spirometri. Jurnal Ilmiah Widya. 2019;6(1):1–6.
10. Lamb K, Theodore D, Bhutta BS. PubMed. Treasure Island (FL): StatPearls Publishing. 2020. Spirometry. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK560526/
11. Damayanti R, Ardiya Garini SKM. Gambaran Nilai Neutrophil-Lymphocyte Ratio (Nlr) Pada Pasien Covid-19 Di Rs Islam Siti Khadijah Palembang Tahun 2020. Repositori Poltekkes Palembang. 2020; Available from: https://repository.poltekkespalembang.ac.id/items/show/2805
12. Barata I. USU. 2019. Perbandingan Sensitivitas Nilai Neutrofil Limfosit Rasio (NLR) Cairan Pleura dan Serum Darah pada Pasien Efusi Pleura Eksudatif.
13. Sari AP, Astari, Pranindya. Nilai Rasio Neutrofil-Limfosit (RNL) Darah dan Kadar Protein C-Reaktif (CRP) Pasien Penyakit Paru Obstruktif Kronik (PPOK) pada Kondisi Eksaserbasi dan Stabil di Rumah Sakit Persahabatan. Neutrophyl-Lymphocyte Ratio (NLR) and C–Reactive Protein (CRP) in Chronic Obstructive Pulmonary Disease (COPD) Patients during Exacerbation and Stable in Persahabatan Hospital Jakarta Indonesia. Universitas Indonesia; 2020. Available from: https://lib.ui.ac.id/detail?id=20514110&lokasi=lokal
14. Departemen Kesehatan RI. Rencana Aksi Nasional Kesehatan Lanjut Usia. Depkes RI. 2019;
15. Hartina S, Wahiduddin W, Rismayanti R. Faktor Risiko Kejadian Penyakit Paru Obstruktif Kronik Pada Pasien Rsud Kota Makassar. Hasanuddin Journal of Public Health. 2021 Jun 30; 2(2): 159–71.
16. Sutradhar I, Das Gupta R, Hasan M, Wazib A, Sarker M. Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease in Bangladesh: A Systematic Review. Cureus. 2019 Jan 28;
17. Rokach A, Bohadana A, Kotek O, Shuali CC, Azulai H, Babai P, et al. Early detection of COPD: An opportunistic case finding study in smokers and ex-smokers visiting a medical centre. International Journal of COPD. 2021; 16: 1519-27.
18. Utomo B, Astuti MF. Beberapa Faktor Risiko Yang Berhubungan Dengan Penyakit Paru Obstruktif Kronik (PPOK) Petugas Kebersihan Di Kota Purwokerto Tahun 2017. Utomo B, Astuti MF; Available from: https://ejournal.poltekkes-smg.ac.id/ojs/index.php/keslingmas/article/download/3796/972
19. Pratiwi A, Safari W, Jatmiko, Hernawan B, Basuki. Hubungan Usia dan Merokok Terhadap Nilai Kapasitas Vital Paksa (KVP) pada Pasien PPOK Stabil Di BBKPM Surakarta. The Relationship of Age and Smoking to The Forced Vital Capacity (FVC) Value in Patients with COPD Stable at BBKPM Surakarta.; Available from:
https://publikasiilmiah.ums.ac.id/bitstream/handle/11617/12782/60.pdf?sequence=1&isAllowed=y
20. Abdullah SS, Taha JH, Ahmed MH, Abdullah KS. The Influence of Age on Pulmonary Function, A Cross Sectional Study on a Sample of Healthy Iraqi Males and Females Population. In: Journal of Physics: Conference Series. Institute of Physics Publishing; 2019.
21. Nurfitriani, Ariesta Devi Mulia. Faktor-Faktor Yang Mempengaruhi Kejadian Penyakit Paru Obstruktif Kronik (PPOK) Pada Pasien Poliklinik Paru Di Rsud Meuraxa. Jurnal Sains Riset. 2021; 11(2): 458. Available from: http://journal.unigha.ac.id/index.php/JSR
22. Siddharthan T, Grigsby MR, Goodman D, Chowdhury M, Rubinstein A, Irazola V, et al. Association between household air pollution exposure and chronic obstructive pulmonary disease outcomes in 13 low- and middle-income country settings. Am J Respir Crit Care Med. 2018 Mar 1; 197(5): 611–20.
23. Milan-Mattos JC, Anibal FF, Perseguini NM, Minatel V, Rehder-Santos P, Castro CA, et al. Effects of natural aging and gender on pro-inflammatory markers. Brazilian Journal of Medical and Biological Research. 2019; 52 (9).
24. Elisia I, Lam V, Cho B, Hay M, Li MY, Yeung M, et al. The effect of smoking on chronic inflammation, immune function and blood cell composition. Sci Rep. 2020 Dec 1; 10 (1).
25. Dauchet L, Hulo S, Cherot-Kornobis N, Matran R, Amouyel P, Edmé JL, et al. Short-term exposure to air pollution: Associations with lung function and inflammatory markers in non-smoking, healthy adults. Environ Int. 2018 Dec 1;121: 610-9.
26. Mauro R Di, Cantarella G, Bernardini R, Rosa M Di, Barbagallo I, Distefano A, et al. The biochemical and pharmacological properties of ozone: The smell of protection in acute and chronic diseases. Vol. 20, International Journal of Molecular Sciences. MDPI AG; 2019.
27. Ye Z, Ai X, Liao Z, You C, Cheng Y. The prognostic values of neutrophil to lymphocyte ratio for outcomes in chronic obstructive pulmonary disease. Medicine (United States). 2019 Jul 1;98(28).
28. Kusumawardani N, Rahajeng E, Mubasyiroh R, Penelitian dan Pengembangan Upaya Kesehatan Masyarakat P, Penelitian dan Pengembangan Sumber Daya dan Pelayanan Kesehatan Badan Penelitian Dan Pengembangan Kesehatan P, Kesehatan KR. Hubungan Antara Keterpajanan Asap Rokok Dan Riwayat Penyakit Paru Obstruktif Kronik (PPOK) Di Indonesia. Associationof Cigarrete Smoke Expossure and Chronic Obstructive Pulmonary Disease (COPD) in Indonesia.
29. Wu D, Meydani SN. Journal of Leukocyte Biology. 2018. Age-associated changes in immune and inflammatory responses: impact of vitamin E intervention. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2538592/
30. Dauchet L, Hulo S, Cherot-Kornobis N, Matran R, Amouyel P, Edmé JL, et al. Short-term exposure to air pollution: Associations with lung function and inflammatory markers in non-smoking, healthy adults. Environ Int. 2018 Dec 1;121: 610-9.
31. Siti Hurul Aini Q. Gambaran Jumlah Neutrofil Darah Tepi Pasien Penyakit Paru Obstruktif Kronik (PPOK) di Ruang Rawat Inap RSUD Arifin Achmad Provinsi Riau Tahun 2017.
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