Korelasi Ankle Brachial Indeks dengan Pulse Wave Handheld Doppler Penderita Kaki Diabetik
Abstract
Tujuan: Untuk mengetahui hubungan antara hasil pemeriksaan Ankle Brachial Index (ABI) dengan gambaran spektral Doppler vaskular pada arteri poplitea, arteri tibialis posterior, dan arteri dorsalis pedis pada penderita kaki diabetik. Metode: 33 pasien kaki diabetes yang memenuhi kriteria inklusi dari RSUP Prof. Dr. R. D. Kandou. Pengukuran ABI dilakukan dan spektral arteri poplitea, tibialis posterior, dan dorsalis pedis diuji menggunakan Pulse Wave Handheld Doppler (PWHD). Hasilnya akan diproses secara statistik menggunakan desain potong lintang untuk mengetahui hubungan keduanya. Hasil: Sebagian dari jumlah pasien memiliki gelombang bifasik di 3 arteri. Gelombang trifasik terlihat dominan di arteri poplitea (56%) dan juga umumnya pada dua arteri lainnya (30%). Gelombang arteri menunjukkan adanya hubungan dengan ABI. Dibanding dengan gelombang bifasik, pasien dengan gelombang trifasik rata-rata memiliki ABI yang meningkat (0,15; p<0,001 pada arteri poplitea, dan 0,06; p=0,006 pada arteri tibialis posterior). Secara nyata, gelombang monofasik cenderung menurunkan ABI pada sejumlah pasien dibandingkan gelombang bifasik (-0,18; p<0,001 pada arteri tibialis posterior dan -0,15; p<0,0041 pada arteri dorsalis pedis). Simpulan: Didapatkan hubungan yang signifikan antara ABI dengan hasil gelombang spektral Doppler pada semua segmen arteri bawah lutut.
Downloads
References
2. Schaper NC, van Netten JJ, Apelqvist J, dkk. IWGDF Practical guidelines on the prevention and management of diabetic foot disease. Netherlands: The International Working Group on the Diabetic Foot; 2019. h.4-5.
3. Nwabudike LC, Ionescu-Tirgoviste C. Risk factors and clinical characteristic for foot ulcers in patients with diabetes in Bucharest, Romania. Proc Rom Acad. 2008;1-2:49-52.
4. Alavi A, Sibbald RG, Mayer D, dkk. Diabetic foot ulcers: Part I. Pathophysiology and prevention. J Am Acad Dermatol. 2014;70:1.e1-18.
5. Lipsky BA, Weigelt JA, Sun X, dkk. Developing and validating a risk score for lower-extremity amputation in patients hospitalized for a diabetic foot infection. Diabetes Care. 2011;34:1695-700.
6. Guariguata L, Whiting DR, Hambleton I, dkk. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103:137-49.
7. Marso SP, Hiatt WR. Peripheral arterial disease in patients with diabetes. J Am Coll Cardiol. 2006;47:921-9.
8. Ikem R, Ikem I, Adebayo O, dkk. An assessment of peripheral vascular disease in patients with diabetic foot ulcer. Foot (Edinb). 2010;20:114-7.
9. Aboyans V, Criqui MH, Abraham P, dkk. Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association. Circulation. 2012;126:2890-909.
10. Xu D, Li J, Zou L, dkk. Sensitivity and specificity of the ankle--brachial index to diagnose peripheral artery disease: a structured review. Vasc Med. 2010;15:361-9.
11. Ischemia. Dalam: Sidawy NA, Perler BA, penyunting. Rutherford’s Vascular Surgery and Endovascular Therapy. 9th Edition. Philadelphia: Elsevier; 2019. h.216-7.
12. Tehan PE, Chuter VH. Use of hand-held Doppler ultrasound examination by podiatrists: a reliability study. J Foot Ankle Res. 2015;8:36.
13. Limpeleh L, Sumangkut RM, Tjandra DE. Korelasi Antara Gambaran Spektral Doppler Arteri Tibialis Posterior dan Arteri Dorsalis Pedis dengan Skor Pedis pada Penderita Ulkus Kaki Diabetik di RSUP Prof. Dr. R. D. Kandou. Jurnal Biomedik: JBM. 2018;10:97-105.
14. Kristiani AL, Sumangkut RM, Limpeleh HP. Hubungan Ankle Brachial Index Dengan Keparahan Ulkus Pada Penderita Kaki Diabetik. Jurnal Biomedik: JBM. 2015;7:171-7.
15. Wagiu AMJ, Sumangkut RM, Sapan HB, Waworuntu LAJ. Perbandingan efektifitas asam perasetik dan feracrylum pada pola kuman ulkus diabetik. Jurnal Biomedik: JBM. 2016;8:51-7.
16. Zaine NH, Burns J, Vicaretti M, dkk. Characteristic of diabetic foot ulcers in Western Sidney, Australia. J Foot Ankle Res. 2014;7:39.
17. Rizk MN, Ameen AI. Comorbidities associated with Egyptian diabetic foot disease subtypes. Egypt J Intern Med. 2013;25:154-8.
18. EFIM Vascular Working Group. Peripheral Arterial Disease Management: A Practical Guide for Internists. European Federation of Internal Medicine [serial online] Mei 2008 [diakses 18 Desember 2019]. Diunduh dari: https://efim.org/system/files/pad_guide.pdf.
19. Diabetic Neuropathy. Dalam: Sidawy NA, Perler BA, penyunting. Rutherford’s Vascular Surgery and Endovascular Therapy. 9th Edition. Philadelphia: Elsevier; 2019. h.1515-34.
20. Norgen L, Hiatt W, Dormandy J, dkk. Inter-society consensus for the management of peripheral artery disease (TASC II). J Vasc Surg. 2007;45 Suppl S:S5-67.
21. Sibley RC III, Reis SP, MacFarlane JJ, dkk. Noninvasive Physiologic Vascular Studies: A Guide to Diagnosing Peripheral Arterial Disease. Radiographics. 2017;37:346-57.
22. Thiruvoipati T, Kielhorn CE, Armstrong EJ. Peripheral artery disease in patients with diabetes: Epidemiology, mechanisms, and outcomes. World J Diabetes. 2015;6:961-9.
23. Mahé G, Boulon C, Desormais I, dkk. Statement for Doppler waveforms analysis. Vasa. 2017;46:337-45.
24. Gupta A, Tyagi VK, Bansal N, dkk. Comparation of Ankle Brachial Pressure Index to Arterial Doppler USG in the Diagnosis of Peripheral Vascular Disease in Diabetes Mellitus. International Journal Advance Medicine. 2017;4:1562-5.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Program Studi Ilmu Bedah Fakultas Kedokteran Universitas Udayana. 
This work is licensed under a Creative Commons Attribution 4.0 International License.
