Mutiara Chairsabella 22010112130070 Lap.KTI Bab7
63
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Lampiran 1.
PROSEDUR PENGUKURAN CIMT
1) Memposisikan pemeriksa dan pasien senyaman mungkin dimana pasien
terbaring pada tempat tidur dan pemeriksa duduk di samping kanan pasien.
2) Mengekstensikan
leher
dan
memposisikan
kepala
pasien
menoleh
kontralateral terhadap sisi leher yang akan diperiksa, kemudian mengoleskan
gel pada leher atau pada transduser.
3) Melakukan skrinning arteri karotis komunis menggunakan transduser dengan
orientasi transversal, dari proksimal hingga distal, sambil melihat layar
monitor hingga menemukan bulbus karotikus.
4) Memposisikan orientasi transduser menjadi longitudinal pada sisi lateral
arteri karotis kemudian merekam pencitraan pada monitor dalam bentuk
gambar diam.
5) Melakukan pengukuran CIMT pada dinding jauh pembuluh darah
menggunakan perangkat lunak pada alat.
6) Melakukan pemeriksaan dan pengukuran CIMT pada sisi leher yang lain
dengan cara yang sama.
7) Mengambil nilai rata – rata CIMT.
72
Lampiran 2. Ethical clearance
73
Lampiran 3. Surat izin melaksanakan penelitian
74
75
Lampiran 4. Informed cosent
76
77
Lampiran 5. Kuesioner
DAFTAR TILIK PENELUSURAN REKAM MEDIK DAN
WAWANCARA
No. CM
:
Nama
:
Jenis kelamin
:
Umur
:
Pekerjaan
:
Alamat
:
No. HP
:
Tinggi badan : _____cm
Laki-laki
Perempuan
Berat badan
: _____ kg
Kontrol teratur/tidak :
Ya
Tidak
Status merokok
Ya
Tidak
:
Tekanan darah
Lama hipertensi
BMI
: _____ kg/m2
Obat yang diminum
terakhir
Data
Hipertensi
Data DM
Status DM
:
Ya
Tidak
Anamnesis 3P + kadar GDS
mg/dl
Anamnesis 3P + kadar GDP
mg/dl
Lainnya (diagnosis dokter, mendapat terapi DM)
78
Kadar gula darah terakhir :
GDP______mg/dl;
GDS______ mg/dl
2PP ______mg/dl
Kadar HbA1c
:
Lama DM
:
Obat yang diminum
:
Data dislipidemia
Status dislipidemia
:
Ya
Tidak
Kadar kolesterol total : ________ mg/dl
(dislipidemia: ≥240 mg/dl)
Kadar kolesterol LDL : ________ mg/dl
(dislipidemia: ≥160 mg/dl)
Kadar kolesterol HDL : ________ mg/dl
(dislipidemia:
DAFTAR PUSTAKA
1. World Health Organization. Global status report on noncommunicable diseases
2014. Geneva: World Health Organization; 2014.
2. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A
comparative risk assessment of burden of disease and injury attributable to 67
risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic
analysis
for
the
Global
Burden
of
Disease
Study 2010.
Lancet.
2012;380(9859):2224–60.
3. World Health Statistics. Causes of death 2008 : data sources and methods.
World Health. 2011;2010(September 2010):1–28.
4. Cardiovascular disease risk factors - Hypertension [Internet]. World Heart
Federation. [cited 2016 Jan 17]. Available from: http://www.world-heartfederation.org/cardiovascular-health/cardiovascular-disease-riskfactors/hypertension/
5. Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N
Engl J Med. 2005;352(16):1685–95.
6. D’Agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et
al. General cardiovascular risk profile for use in primary care: the Framingham
Heart Study. Circulation. 2008 Feb 12;117(6):743–53.
7. Bouhanick B, Barbosa SLS, Marre M. Hypertension and diabetes. Arch Mal
Coeur Vaiss. 2000;93(11, S):1429–34.
8. IDF Diabetes ATLAS. 7th ed. Brussels: International Diabetes Federation;
2015. 12-7 p.
9. WHO | Diabetes [Internet]. World Health Organization; [cited 2015 Nov 23].
Available from: http://www.who.int/mediacentre/factsheets/fs312/en/
10. American Heart Association. Cardiovascular Disease & Diabetes [Internet].
[cited
2015
Nov
23].
Available
from:
http://www.heart.org/HEARTORG/Conditions/Diabetes/WhyDiabetesMatters/
Cardiovascular-Disease-Diabetes_UCM_313865_Article.jsp/#.VlJnCtLhDIV
63
64
11. Perk J, De Backer G, Gohlke H, Graham I, Reiner Ž, Verschuren M, et al.
European Guidelines on Cardiovascular Disease Prevention in Clinical
Practice. The Fifth Joint Task Force of the European Society of Cardiology and
Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur
Heart J. 2012;33(13):1635–701.
12. Hong YM. Atherosclerotic cardiovascular disease beginning in childhood.
Korean Circ J. 2010;40(1):1–9.
13. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson Jr.
SK. Carotid-artery intima and media thickness as a risk factor for myocardial
infarction and stroke in older adults. Cardiovascular Health Study
Collaborative Research Group. N Engl J Med. 1999;340(1):14–22.
14. Gómez-Marcos MA, Recio-Rodríguez JI, Rodríguez-Sánchez E, PatinoAlonso MC, Magallón-Botaya R, Martínez-Vizcaino V, et al. Carotid IntimaMedia Thickness in Diabetics and Hypertensive Patients. Rev Española Cardiol
(English Ed. Elsevier; 2011 Jul 1;64(7):622–5.
15. Alatab S, Fakhrzadeh H, Sharifi F, Mostashfi A, Mirarefin M, Badamchizadeh
Z, et al. Impact of hypertension on various markers of subclinical
atherosclerosis in early type 2 diabetes. J Diabetes Metab Disord.
2014;13(1):24.
16. Marieb EN, Hoehn K. Human Anatomy & Physiology. 7th ed. San Francisco:
Benjamin Cummings; 2006.
17. Mescher AL. Junqueiras’s Basic Histology: Text and Atlas. 13th ed. New
York: McGraw-Hill Education; 2013. 217-24 p.
18. Kumar V, Abbas AK, Aster JC. Robbins Basic Pathology. 9th ed.
Philadelphia: Elsevier Saunders; 2013. 335-43 p.
19. Libby P. The Pathogenesis, Prevention, and Treatment of Atherosclerosis. In:
Kasper DL, Hauser SL, Jameson JL, Fauci AS, Longo DL, Loscalzo J, editors.
Harrison’s Principles of Internal Medicine. 19th ed. McGraw-Hill Education;
2015. p. 291e1–10.
20. Steinl DC, Kaufmann BA. Ultrasound imaging for risk assessment in
atherosclerosis. Int J Mol Sci. Multidisciplinary Digital Publishing Institute;
65
2015 Jan 29;16(5):9749–69.
21. Sherwood L. Fisiologi Manusia: dari Sel ke Sistem. 6th ed. Jakarta: Penerbit
Buku Kedokteran EGC; 2012.
22. Finn A V, Nakano M, Narula J, Kolodgie FD, Virmani R. Concept of
vulnerable/unstable plaque. Arterioscler Thromb Vasc Biol. 2010 Jul
1;30(7):1282–92.
23. Antman EM, Loscalzo J. Ischemic Heart Disease. In: Kasper DL, Hauser SL,
Jameson JL, Fauci AS, Longo DL, Loscalzo J, editors. Harrison’s Principles of
Internal Medicine. 19th ed. McGraw-Hill Education; 2015. p. 1578–92.
24. Coronary Artery Disease [Internet]. National Library of Medicine; [cited 2016
Jan
9].
Available
from:
https://www.nlm.nih.gov/medlineplus/coronaryarterydisease.html
25. Coronary Artery Disease - Coronary Heart Disease [Internet]. [cited 2016 Jan
9].
Available
from:
http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/
Coronary-Artery-Disease---Coronary-HeartDisease_UCM_436416_Article.jsp#.VpENI7aLTIU
26. Antono D, Hamonangani R. Penyakit Arteri Perifer. In: Setiati S, Idrus A,
Sudoyo A w, Simadibrata K. M, Setiyohadi B, Syam AF, editors. Buku Ajar
Ilmu Penyakit Dalam. 6th ed. Jakarta: InternaPublishing; 2014. p. 1518–28.
27. Ropper AH, Samuels MA. Cerebrovascular Disease. In: Adams and Victor’s
Principle of Neurology. 9th ed. New York: McGraw-Hill; 2009. p. 746.
28. Ischemic Stroke | Internet Stroke Center [Internet]. [cited 2016 Jan 17].
Available from: http://www.strokecenter.org/patients/about-stroke/ischemicstroke/
29. History of the Framingham Heart Study [Internet]. [cited 2016 Jan 8].
Available from: https://www.framinghamheartstudy.org/about-fhs/history.php
30. Hackam DG, Anand SS. Emerging Risk Factors for Atherosclerotic Vascular
Disease: A Critical Review of the Evidenc. JAMA. 2003;290(7):932–40.
31. Strom JB, Libby P. Atherosclerosis. In: Lily L, editor. Pathophysiology of
Heart Disease. 5th ed. Walter Kluwer; 2011. p. 113–4.
66
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Lampiran 1.
PROSEDUR PENGUKURAN CIMT
1) Memposisikan pemeriksa dan pasien senyaman mungkin dimana pasien
terbaring pada tempat tidur dan pemeriksa duduk di samping kanan pasien.
2) Mengekstensikan
leher
dan
memposisikan
kepala
pasien
menoleh
kontralateral terhadap sisi leher yang akan diperiksa, kemudian mengoleskan
gel pada leher atau pada transduser.
3) Melakukan skrinning arteri karotis komunis menggunakan transduser dengan
orientasi transversal, dari proksimal hingga distal, sambil melihat layar
monitor hingga menemukan bulbus karotikus.
4) Memposisikan orientasi transduser menjadi longitudinal pada sisi lateral
arteri karotis kemudian merekam pencitraan pada monitor dalam bentuk
gambar diam.
5) Melakukan pengukuran CIMT pada dinding jauh pembuluh darah
menggunakan perangkat lunak pada alat.
6) Melakukan pemeriksaan dan pengukuran CIMT pada sisi leher yang lain
dengan cara yang sama.
7) Mengambil nilai rata – rata CIMT.
72
Lampiran 2. Ethical clearance
73
Lampiran 3. Surat izin melaksanakan penelitian
74
75
Lampiran 4. Informed cosent
76
77
Lampiran 5. Kuesioner
DAFTAR TILIK PENELUSURAN REKAM MEDIK DAN
WAWANCARA
No. CM
:
Nama
:
Jenis kelamin
:
Umur
:
Pekerjaan
:
Alamat
:
No. HP
:
Tinggi badan : _____cm
Laki-laki
Perempuan
Berat badan
: _____ kg
Kontrol teratur/tidak :
Ya
Tidak
Status merokok
Ya
Tidak
:
Tekanan darah
Lama hipertensi
BMI
: _____ kg/m2
Obat yang diminum
terakhir
Data
Hipertensi
Data DM
Status DM
:
Ya
Tidak
Anamnesis 3P + kadar GDS
mg/dl
Anamnesis 3P + kadar GDP
mg/dl
Lainnya (diagnosis dokter, mendapat terapi DM)
78
Kadar gula darah terakhir :
GDP______mg/dl;
GDS______ mg/dl
2PP ______mg/dl
Kadar HbA1c
:
Lama DM
:
Obat yang diminum
:
Data dislipidemia
Status dislipidemia
:
Ya
Tidak
Kadar kolesterol total : ________ mg/dl
(dislipidemia: ≥240 mg/dl)
Kadar kolesterol LDL : ________ mg/dl
(dislipidemia: ≥160 mg/dl)
Kadar kolesterol HDL : ________ mg/dl
(dislipidemia: