terhadap penurunan kadar il-6 dan hs-crp pada … · cerp = cholesterol efflux regulatory protein...

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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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Page 1: TERHADAP PENURUNAN KADAR IL-6 DAN HS-CRP PADA … · CERP = Cholesterol Efflux Regulatory Protein ELISA = Enzyme Linked Immunosorbent Assay HDL = High Density Lipoprotein HS-CRP =

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…………………………………...….

15

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…….…………………..

43

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…………………..

46

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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