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All Journal Health and Medical Journal Jurnal Penyakit Dalam Indonesia
Fadella, Annesa
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Korelasi antara Kadar Interleukin-6 dengan Kadar Reverse Triiodothyronine dan Kadar Hormon Tiroid Lainnya pada Pasien Sakit Kritis dengan Non-Thyroidal Illness Syndrome Aprilia, Dinda; Decroli, Eva; Fadella, Annesa
Health and Medical Journal Vol 7, No 1 (2025): HEME January 2025
Publisher : Universitas Baiturrahmah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33854/heme.v7i1.1639

Abstract

Pendahuluan: Penyakit kritis dapat disertai dengan perubahan hormon tiroid. Non-thyroidal illness syndrome (NTIs) adalah kelainan tes fungsi tiroid ditandai dengan penurunan kadar triiodothyronine (T3) dan peningkatan kadar reverse triiodothyronine (RT3) pada pasien dengan penyakit sistemik non-tiroid berat tanpa kelainan tiroid sebelumnya dan interleukin (IL)-6 dikatakan terlibat dalam patogenesis NTIs. Tujuan: Mengetahui rerata kadar IL-6, Thyroid Stimulating Hormone (TSH), T3, Thyroxine (T4) dan RT3 pada pasien kritis; Mengetahui hubungan kadaar IL-6 dengan kadar TSH, T3, T4 dan RT3 pada pasien kritis; Mengetahui angka kejadian NTIs. Metode: Penelitian ini merupakan penelitian observasional analitik dengan desain cross-sectional yang dilakukan di RSUP Dr. M. Djamil Padang pada 30 pasien kritis yang memenuhi kriteria inklusi dan eksklusi. Dilakukan pemeriksaan kadar IL-6, TSH, T3, T4 dan RT3. Hasil: Pada penelitian didapatkan rerata kadar IL-6 adalah 37,457 (24,70) pg/ml dan rerata kadar TSH, T3, T4 dan RT3 secara berurutan adalah 1,19 (1,12) uIU/ml, 0,486 (0,30) nmol/L, 60,87 (27,19) nmol/L dan 181,84 (72,10) ng/dL. Terdapat korelasi yang signifikan (p<0.05) dengan arah korelasi negatif dan kekuatan korelasi lemah (r=-0.319) antara IL-6 dan TSH, korelasi kuat (r=-0.6) antara IL-6 dan T3, korelasi lemah (r=-0,302) antara IL-6 dan T4. Terdapat korelasi yang signifikan (p<0,05) dengan korelasi positif dan korelasi sangat kuat (0,944) antara IL-6 dan RT3. Angka kejadian NTI 96,67% dengan gambaran kombinasi hormon terbanyak yaitu TSH normal, T3, T4 rendah, RT3 tinggi sebesar 46,7%. Kesimpulan: Terdapat korelasi negatif antara kadar IL-6 dengan kadar TSH, T3, T4 dan korelasi positif antara kadar IL-6 dan kadar RT3 pada pasien sakit kritis.
Hubungan Faktor Psikologis dengan Atrium Fibrilasi: Suatu Tinjauan Kepustakaan Murni, Arina Widya; Fadella, Annesa
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Psychological factors influence the onset of cardiac rhythm and dysrhythmia disorders, including atrial fibrillation (AF), which is defined as uncoordinated atrial activation resulting in ineffective contractions. Psychological factors have a bidirectional relationship with AF, as AF symptoms can lead to a decline in mental health, which in turn negatively affects the clinical course. One explanation for how psychological stress impacts the heart and contributes to AF involves the autonomic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Anxiety and depression are common comorbidities in AF. These conditions can be assessed using standardized instruments, such as the Hospital Anxiety and Depression Scale (HADS), which includes subscales for anxiety (HADS-A) and depression (HADS-D). Additionally, the Beck Depression Inventory (BDI) can be used to assess depression, while the State-Trait Anxiety Inventory (STAI) is useful for evaluating anxiety. Management of psychosomatic disorders requires a bio-psycho-socio-spiritual approach, involving both non-pharmacological and pharmacological therapies. Key components include somatic or symptomatic therapy, psychotherapy or sociotherapy, and psychopharmacotherapy, with the choice of method depending on various factors. In AF patients, treatment of psychological stress, anxiety, and depression generally prioritizes non-pharmacological approaches, such as supportive psychotherapy. If necessary, short-term use of benzodiazepines as anti-anxiety medication can be considered. In cases requiring antidepressants, newer agents such as selective serotonin reuptake inhibitors (SSRIs) are preferred, with close monitoring of heart rhythm due to the potential arrhythmogenic effects of certain medications, especially non-selective antidepressants.
Co-Authors Aprilia, Dinda Arina Widya Murni Eva Decroli