ANALISIS HUBUNGAN ANTARA GEJALA KLINIK, LAMA SAKIT, SKIN PRICK TEST, JUMLAH EOSINOFIL DAN NEUTROFIL MUKOSA SINUS DENGAN INDEKS LUND-MACKAY CT SCAN SINUS PARANASAL PENDERITA RINOSINUSITIS KRONIK (THE RELATIONSHIP ANALYSIS BETWEEN CLINICAL SYMPTOMS, ILNESS DURATION, SKIN PRICK TEST, EOSINOPHIL AND NEUTROPHIL OF SINUSES MUCOSA WITH LUND-MACKAY INDEX OF PARANASAL SINUSES CT SCAN IN CHRONIC RHINOSINUSITIS’S PATIENTS)

Abstract

ABSTRAK Latar Belakang: Beberapa studi terpisah telah menghubungkan antara indeks Lund-MacKay CT scan untuk menilai abnormalitas luas mukosa sinus dengan gejala klinik, jumlah eosinofil dan neutrofil, namun belum ada penelitian secara komprehensif mengkaitkan hubungan antar variabel tersebut. Penelitian ini bertujuan untuk menganalisis hubungan antara gejala klinik, skin prick test, jumlah eosinofil dan neutrofil mukosa sinus dengan indeks Lund-MacKay CT scan sinus paranasal penderita rinosinusitis kronik. Metode: Penelitian kasus-kontrol menggunakan pasien rinosinusitis kronik diperiksa CT scan sinus paranasal terhadap 41 subyek yang memenuhi kriteria inklusi dan eksklusi di SMF KTHT-KL RSUP Dr. Kariadi Semarang. Sampel dengan indeks Lund-MacKay ≥6 adalah kelompok kasus, dan indeks Lund-MacKay <6 adalah kelompok kontrol. Semua sampel diambil data klinik dan skin prick test. Sediaan mikroskopik mukosa sinus hasil operasi FESS dipulas dengan HE, dihitung jumlah eosinofil dan neutrofil per LPB. Data dideskripsikan dalam tabel dan gambar, diuji Chi square, rasio odds dan regresi logistik dengan SPSS for Windows 11.5. Hasil: Uji Chi square variabel skor gejala klinik dengan indeks Lund-MacKay didapatkan bermakna (p=0,005). Uji variabel lama sakit dengan indeks Lund-MacKay didapatkan bermakna (p=0,017). Uji hasil skin prick test dengan indeks Lund-MacKay didapatkan bermakna (p=0,001). Uji jumlah eosinofil dengan indeks Lund-MacKay didapatkan bermakna (p=0,003). Uji jumlah neutrofil dengan indeks Lund-MacKay didapatkan tidak bermakna (p=0,731). Analisis regresi logistik didapatkan nilai p>0,05 (tidak signifikan) untuk semua variabel. Analisis Spearman yang menghasilkan korelasi positif kuat yaitu antara skin prick test dengan indeks Lund-MacKay (r = 0,513) dan antara jumlah eosinofil dengan indeks Lund-MacKay (r = 0,564). Simpulan: Gejala klinik, lama sakit, skin prick test, jumlah eosinofil berhubungan dengan indeks Lund-McKay CT scan penderita rinosinusitis kronik. Kata Kunci: gejala klinik, skin prick test, jumlah eosinofil & neutrofil, indeks Lund-MacKay ABSTRACT Background: Several separate studies explain the relationship between Lund-MacKay index to evaluate the extension of mucosa sinus abnormality with clinical findings, eosinophil and neutrophil, but there are no study describe those variables comprehensively. The study is aimed to analyze the relationship between clinical symptoms, skin prick test, eosinophil and neutrophil of sinus mucosa with Lund-MacKay index of paranasal sinuses CT scan. Methods: This was a case-controll study using 41 chronic rhinosinusitis patients who came to ENT-HNS Department of Kariadi Hospital Semarang during October 2008 to April 2009 as sample. The sample with Lund-MacKay index ≥6 were the case group, and other with Lund-MacKay index <6 was the controll group. All samples were clinically recorded and undergoing skin prick test. The sinuses mucosa specimen from FESS were processed in HE, the eosinophil and neutrophil counts were measured per high power field (HPF). The data were described in table and figures, analysed using Chi square test, odds ratio (OR) and logistic regresion using SPSS for Windows 11.5. Result: The Chi square for clinical symptoms with Lund-MacKay index was significant (p=0,005). For duration of symptoms variabel with Lund-MacKay index was significant (p=0,017). For skin prick test with Lund-MacKay index was significant (p=0,001). For eosinophil with Lund-MacKay index was significant (p=0,003). For neutrophil with Lund-MacKay index was not significant (p=0,731). The logistic regresion analysis were p>0,05 (not significant) for all variables. The Spearman correlation with strong-positive were skin prick test with Lund-MacKay index (r = 0,513), eosinophil with Lund-MacKay index (r = 0,564). Conclusion: The clinical and duration of symptom, skin prick test and eosinophil relate to the Lund-MacKay index of CT scan in chronic rhinosinusitis patients. Key Words: Clinical symptom, skin prick test, eosinophil & neutrophil counts, Lund-MacKay index