HUBUNGAN ANTARA INTERLEUKIN- 6 DAN C-REACTIVE PROTEIN PADA SIROSIS HATI DENGAN PERDARAHAN SALURAN MAKANAN BAGIAN ATAS

Abstract

Variceal bleeding is a frequent complication of liver cirrhosis. Upper gastrointestinal (GI) bleeding is a risk factor for
infection. The severity of liver cirrhosis was correlated with infection and GI bleeding. Bacterial infection and endotoxin promote
cytokine proinflammation (IL-6) release from monocyte. IL-6 stimulates the liver to produce CRP. Does liver cirrhosis
affect the CRP production? Recently, there are no data about the correlation of IL-6 and CRP in liver cirrhosis with upper
gastrointestinal bleeding. A cross-sectional analytic study was performed to describe the correlation between IL-6 and CRP in
liver cirrhosis patient with upper gastrointestinal bleeding.
We performed a cross-sectional analytic study in 52 liver cirrhosis patients. The liver cirrhosis patients with upper
gastrointestinal bleeding in last 14 days, absence of steroid and statin treatment, without hepatoma, and GFR 15 ml/mnt/1.73
m2, were collected consecutively. The correlation of IL-6 and CRP was analyzed with Pearson correlation test, mean difference
of CRP between Child Turcotte Pugh (CTP) group was analyzed by Ancova test continued with post hoc Tamhane test, the effect
of CTP on CRP production was analyzed with Ancova test.
Seventy-five percent out of 52 samples were male and the rest were female. Two of them (3.8%) with CTP score A, 20
(38.5%) CTP score B and 30 (57.7%) CTP score C. Mean of IL-6 was 28.29 ± 34.60. Mean of CRP was 17.17 ± 28.80 mg/L. We
found strong positive correlation between IL-6 and CRP (r = 0.610; p<0.001). CTP score didnt have significant independent
effect on correlation of IL-6 and CRP level (F=2.33; p=0.108). Significant mean difference of CRP was found between CTP score
group (F=4.27; p=0.02).
In conclusion, Interleukin-6 has a strong correlation with CRP in liver cirrhosis with upper GI bleeding. CRP level is
significantly higher in severe liver cirrhosis. And the degree of liver damage doesnt have significant independent effect on
correlation of IL-6 and CRP level. These results show us that hepatocyte in liver cirrhosis still adequately produce CRP.