Gambaran Radiologis Paru dengan Nilai Laju Endap Darah (LED) pada Pasien Tuberculosis Paru dengan Diabetes Melitus Tipe 2 Tidak Terkontrol di RSU Royal Prima Medan
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Tuberkulosis (TB) paru dengan Diabetes Melitus (DM) tipe 2 tidak terkontrol dapat memperberat proses inflamasi dan meningkatkan kerusakan paru. Gambaran radiologis paru digunakan untuk menilai derajat keparahan lesi, sedangkan Laju Endap Darah (LED) merupakan biomarker inflamasi yang dapat mencerminkan aktivitas penyakit. Penelitian ini bertujuan menganalisis hubungan gambaran radiologis paru dengan nilai LED pada pasien TB paru dengan DM tipe 2 tidak terkontrol di RSU Royal Prima Medan. Penelitian ini menggunakan desain analitik observasional dengan pendekatan cross-sectional. Sampel berjumlah 100 pasien yang dipilih menggunakan teknik total sampling berdasarkan data rekam medis periode 2023–2025. Gambaran radiologis paru diklasifikasikan menjadi minimal, moderately advanced, dan far advanced. Data dianalisis menggunakan analisis univariat dan uji korelasi Spearman dengan tingkat kemaknaan ? = 0,05. Hasil penelitian menunjukkan sebagian besar pasien memiliki gambaran radiologis moderately advanced (43,0%), diikuti far advanced (35,0%) dan minimal (22,0%). Nilai rerata LED adalah 81,34 ± 30,03 mm/jam dan seluruh pasien (100%) memiliki nilai LED meningkat. Uji Spearman menunjukkan hubungan positif yang sangat kuat dan bermakna antara gambaran radiologis paru dengan nilai LED (r? = 0,931; p < 0,001). Disimpulkan bahwa semakin berat gambaran radiologis paru, semakin tinggi nilai LED pada pasien TB paru dengan DM tipe 2 tidak terkontrol di RSU Royal Prima Medan.
Abbas, A. K., Lichtman, A. H., & Pillai, S. (2021). Cellular and molecular immunology (10th ed.). Elsevier.
American Diabetes Association. (2023). Standards of care in diabetes—2023. Diabetes Care, 46(Suppl. 1), S1–S291. https://doi.org/10.2337/dc23-Sint
Barreda, R., Sánchez, J., & Gómez, M. (2020). Anemia in pulmonary tuberculosis patients and its association with disease severity. International Journal of Tuberculosis and Lung Disease, 24(5), 523–530.
Bommer, C., Heesemann, E., Sagalova, V., Manne-Goehler, J., Atun, R., Bärnighausen, T., & Vollmer, S. (2017). The global economic burden of diabetes in adults aged 20–79 years. Diabetes Care, 40(9), 1297–1305.
Brooks, G. F., Carroll, K. C., Butel, J. S., Morse, S. A., & Mietzner, T. A. (2022). Jawetz, Melnick, & Adelberg’s medical microbiology (29th ed.). McGraw-Hill Education.
Centers for Disease Control and Prevention. (2022). Tuberculosis (TB): Transmission and pathogenesis. U.S. Department of Health and Human Services.
DeFronzo, R. A., Ferrannini, E., Groop, L., Henry, R. R., Herman, W. H., Holst, J. J., Hu, F. B., & Kahn, C. R. (2021). Type 2 diabetes mellitus. Nature Reviews Disease Primers, 7(1), 1–31.
Felson, B. (2020). Felson’s principles of chest roentgenology: A programmed text (5th ed.). Elsevier.
Foe-Essomba, J. R., Kenmoe, S., & Bigna, J. J. (2021). Tuberculosis and diabetes mellitus comorbidity: A syndemic relationship and its impact on public health. BMC Infectious Diseases, 21(1), 1–10.
Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., ... & Yeboah, J. (2019). 2018 AHA/ACC guideline on cholesterol management. Circulation, 139(25), e1082–e1143.
Guyton, A. C., & Hall, J. E. (2021). Textbook of medical physiology (14th ed.). Elsevier.
Hansell, D. M., Bankier, A. A., MacMahon, H., McLoud, T. C., Müller, N. L., & Remy, J. (2020). Fleischner Society: Glossary of terms for thoracic imaging. Radiology, 246(3), 697–722.
Hotamisligil, G. S. (2017). Inflammation, metaflammation and immunometabolic disorders. Nature, 542(7640), 177–185. https://doi.org/10.1038/nature21363
Huang, L., Nazarova, E. V., & Russell, D. G. (2017). Clinical and radiological features of pulmonary tuberculosis in patients with diabetes mellitus. Clinical Infectious Diseases, 65(6), 1015–1022.
Huang, Y., Chen, X., Zhang, L., & Wang, H. (2022). Hematological changes in pulmonary tuberculosis patients with diabetes mellitus. BMC Infectious Diseases, 22(1), 1–10.
International Diabetes Federation. (2023). IDF diabetes atlas (10th ed.). International Diabetes Federation.
Jeon, C. Y., & Murray, M. B. (2008). Diabetes mellitus increases the risk of active tuberculosis: A systematic review. PLoS Medicine, 5(7), e152. https://doi.org/10.1371/journal.pmed.0050152
Jung, Y. J., Lee, J. Y., & Park, S. Y. (2023). Radiologic manifestations and laboratory markers in tuberculosis patients with type 2 diabetes mellitus: A systematic review. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 31, 100350.
Kementerian Kesehatan Republik Indonesia. (2023). Pedoman nasional pelayanan kedokteran tatalaksana tuberkulosis. Direktorat Jenderal P2P.
Lonnroth, K., Jaramillo, E., Williams, B. G., Dye, C., & Raviglione, M. (2019). Drivers of tuberculosis epidemics: The role of risk factors and social determinants. Social Science & Medicine, 215, 1–9.
Meng, X., Zhang, L., Chen, Y., & Wang, H. (2023). The impact of type 2 diabetes mellitus on tuberculosis progression and immune response. Frontiers in Endocrinology, 14, 1182456.
Miyahara, R., Piyaworawong, S., & Naranbhai, V. (2019). Neutrophil-to-lymphocyte ratio as a prognostic marker in pulmonary tuberculosis patients. Respiratory Medicine, 158, 105–111.
Omair, A., Khan, M. A., & Alshammari, A. (2024). Hematological parameters as markers of systemic inflammation in pulmonary tuberculosis. BMC Pulmonary Medicine, 24(1), 1–9.
Perhimpunan Dokter Paru Indonesia. (2022). Pedoman diagnosis dan penatalaksanaan tuberkulosis di Indonesia. PDPI.
Weiss, G., & Ganz, T. (2021). Anemia of inflammation. New England Journal of Medicine, 384(11), 1011–1023. https://doi.org/10.1056/NEJMra1916183
World Health Organization. (2024). Global tuberculosis report 2024. WHO.
Zhan, X., Wu, Z., Liang, J., & Liu, Q. (2022). Radiographic patterns of pulmonary tuberculosis in patients with diabetes mellitus. European Journal of Radiology, 150, 110234.
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