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RESPON ASTROSIT SEBAGAI PREDIKTOR LUARAN KLINIS PADA PENDERITA STROKE ISKEMIK AKUT SIRKULASI ANTERIOR: Tinjauan Kadar Glial Fibrillary Acidic Protein (GFAP), Transforming Growth Factor- Beta 1 (TGF-β1), Vascular Endothelial Growth Factor (VEGF) dan Brain-Derived Neurothropic Factor (BDNF) Serum

ASTROCYTE RESPONSES AS A PREDICTOR OF CLINICAL OUTCOME OF ACUTE ISCHEMIC STROKE PATIENTS IN ANTERIOR CIRCULATION: Study on Glial Fibrillary Acidic Protein (GFAP), Transforming Growth Factor- Beta1 (TGF-β1), Vascular Endothelial Growth Factor (VEGF) and Brain-Derived Neurothropic Factor (BDNF) Serum Level

2015
Disertasi/PhD Theses from #PUBLISHER# / 2016-01-06 11:27:59
Oleh : VIVIEN PUSPITASARI
Dibuat : 2016-01-06, dengan 1 file

Keyword : kadar BDNF, GFAP, TGF-β1,VEGF serum, stroke iskemik akut, luaran klinis

VIVIEN PUSPITASARI. Respon Astrosit Sebagai Prediktor Luaran Klinis Pada Penderitas Stroke Iskemik Akut Sirkulasi Anterior: Tinjauan Kadar Glial Fibrillary Acidic Protein (GFAP), Transforming Growth Factor-Beta 1 (TGF-β1), Vascular Endothelial Growth Factor (VEGF) dan Brain-Derived Neurothropic Factor (BDNF) Serum (dibimbing oleh Syarifuddin Wahid, Amiruddin Aliah, dan FX Budhianto Suhadi)Penelitian ini bertujuan untuk mengetahui hubungan antara respon astrosit yang ditandai oleh kadar GFAP serum, kadar TGF-β1, VEGF dan BDNF serum pada fase akut stroke iskemik dengan luaran klinis.Penelitian ini menggunakan disain kohort longitudinal, terhadap 64 pasien stroke iskemik akut sirkulasi anterior yang baru pertama kali mengalami stroke, dibuktikan dengan Diffusion-Weighted Magnetic Resonance Imaging (DWI-MRI) kepala.. Pemeriksaan kadar GFAP, TGF-β1, VEGF dan BDNF serum dilakukan pada 72 jam dan hari ke-7 pasca awitan stroke dan dinilai luaran klinis pada hari ke-30 dengan menggunakan skor NIHSS. Analisis data menggunakan metode analisis statistitik uji T, uji Spearman dan regresi logistik.Hasil penelitian menunjukkan respon astrosit yang ditandai dengan kadar GFAP dan VEGF serum pada penderita stroke iskemi akut sirkulasi anterior berhubungan dengan luaran klinis yang buruk 30 hari pasca stroke (r=0.657 p=0.006; r=0.518 p=0.04). Kadar VEGF serum pada fase akut stroke dapat digunakan sebagai prediktor luaran klinis yang buruk pada hari ke-30 pasca awitan stroke (OR 6.5;95%CI 1.15-36.61; p=0.034), namun demikian dinamika kenaikan kadar VEGF memperlihatkan efek proteksi dan memperbaiki luaran klinis pada 30 hari pasca awitan. Sedangkan kadar TGF-β1 dan BDNF serum juga menunjukkan efek proteksi terhadap luaran klinis hari ke-30 pasca awitan stroke.Kata kunci: kadar BDNF, GFAP, TGF-β1,VEGF serum, stroke iskemik akut,luaran klinis x

Deskripsi Alternatif :

VIVIEN PUSPITASARI. Astrocytes Responses as A Predictor of Clinical Outcome of Acute Ischemic Stroke Patients in Anterior Circulation; Study on Glial Fibrillary Acidic Protein (GFAP), Transforming Growth Factor-Beta 1 (TGF-β1), Vascular Endothelial Growth Factor (VEGF) and Brain-Derived Neurothropic Factor (BDNF) Serum Level (Supervised by Syarifuddin Wahid, Amiruddin Aliah, FX Budhianto Suhadi)The aim of this study is to determine the relationship between responses of astrocytes marked by GFAP, TGF-β1, VEGF and BDNF level in serum in the acute phase of ischemic stroke patients with clinical outcome.This longitudinal cohort study was conducted on 64 patients suffering from first-attack of anterior circulation blockage as evidence by cephalic Diffusion-Weighted Magnetic Resonance Imaging (DWI-MRI). GFAP, TGF-β1, VEGF and BDNF serum levels were measured by taking blood samples at 72 hours and 7 days after stroke and clinical outcomes were assessed on day-30 after stroke using National Institute of Health Score (NIHSS). T-test, Spearman and logistic regression were used for statistic analyzes.The study results showed the response of astrocytes are characterized by levels of GFAP and VEGF serum in patients with stroke ischemic acute anterior circulation associated with poor clinical outcomes 30 days after stroke ( r = 0657 p = 0.006 ; r = 0518 p = 0.04 ) . Serum VEGF levels in the acute phase of stroke can be used as a predictor of poor clinical outcomes at day 30 after the onset of stroke ( OR 6.5 ; 95 % CI 1.15-36.61 ; p = 0.034 ) , however subjects who have increasing levels of VEGF on day-7 compared to 72 hour tend to have better clinical outcomes on day-30. While the levels of TGF - β1 and BDNF serum also showed a protective effect against the clinical outcomes at 30 day after stroke.Keywords: acute ischemic stroke, clinical outcomes, serum level of BDNF, GFAP,TGF-β1, VEGF

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