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Ruhaya Fitrina
"Latar Belakang: Ankle Brachial Index (ABI) merupakan pemeriksaan noninvasif sederhana dan akurat untuk penyaring dan diagnostik Penyakit Arteri Perifer (PAP). Nilai ABI abnormal merupakan prediktor penting terjadi aterosklerosis sistemik yang menjadi penyebab stroke dan penyakit kardiovaskuler. Nilai ABI rendah berhubungan dengan telah tezjadi aterosklerosis sistemik atau PAP. Setelah lima tahun kemudian 25-35% penderita PAP akan mendenita stroke atau infark miokard. Faktor risiko stroke iskemik yang berhubungan dengan proses aterosklerosis adalah hipertensi, dislipidemia, homosisteinemia, merokok, infeksi dan hiperglikemia.
Tujuan: Mengetahui gambaran nilai ankle brachial index pada penderita stroke iskemik di RSUPN Cipto Mangunkusumo Jakarta.
Metode: Penelitian ini dilakukan menggunakan disain potong lintang deskriptif analitik pada 73 penderita stroke iskemik. Kemudian dilakukan anamnesis, pemeriksaan fisik umum, pemeriksaan neurologi rutin, pemeriksaan kadar total kolesterol darah, trigliserida, LDL, HDL, GDS, dan dilakukan pemeriksaan ABI. Pasien yang tidak memiliki CT scan / MRI kepala tidak masuk dalam penelitian.
Hasil: Dari 73 subyek penelitian didapatkan sebaran umur terbanyak pada kelompok umur 55-64 tahun (42,5%) dan sebagian besar subyek (78.1%) memiliki hipertensi. Proporsi nilai ABI abnormal pada penderita stroke iskemik adalah 26,0 %. Faktor risiko yang bermakna Secara Statistik dengan analisis bivariat adalah kadar total kolesterol darah p=0,039 dan umur p=0,034. Seclangkan hasil analisis multivariate menunjukkan bahwa kelompok umur merupakan faktor risiko independen yang bermakna terhadap nilai ABI abnormal dengan p-value 0,023 (OR 2,556; IK 95% 1,136-5,752).
Kesimpulan: Penderita stroke iskemik berumur lebih dari 55 tahun merupakan faktor risiko yang berhubungan terhadap kejadian nilai ABI abnormal. Sedangkan hiperkolesterolemia merupakan faktor risiko yang mempunyai hubungan yang bermakna dengan nilai ABI abnormal."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2007
T21316
UI - Tesis Membership  Universitas Indonesia Library
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Sophia Utami
"Latar Belakang: Penyakit arteri perifer (PAP) adalah manifestasi aterosklerosis sistemik, yang seringkali melibatkan penyandang diabetes melitus (DM) tipe 2. Tes ankle brachial index (ABI) telah digunakan sebagai penapis PAP, tetapi ABI normal belum menyingkirkan PAP. USG dupleks (UD) lebih sensitif namun lebih mahal daripada tes ABI, sehingga perlu diketahui karakteristik penyandang DM tipe 2 yang paling diprioritaskan untuk menjalani pemeriksaan UD.
Tujuan: Tujuan penelitian ini adalah untuk membuktikan bahwa UD dapat mendeteksi PAP pada penyandang DM tipe 2 dengan ABI normal, mengenali gambaran UD PAP, dan mengenali karakteristik penyandang DM tipe 2 yang paling diprioritaskan untuk menjalani pemeriksaan UD.
Bahan dan Cara Kerja: Penelitian ini menggunakan desain potong lintang dengan mengikutsertakan 40 tungkai. Setiap subyek menjalani roc ABI, pemeriksaan UD dan pen ilaian faktor-faktor risiko. Arteri-arteri ekstremitas bawah d iperiksa, dengan penilaian terhadap ketebalan kompleks intima media (KIM) arteri femoralis, adanya plak, dan evaluasi spektrum Doppler.
Hasil: Dari pemeriksaan UD ditemukan PAP pada 50% (20 dari 40) tungkai. Gambaran UD PAP yang didapatkan berupa penebalan KIM arteri femoralis (20%, 4 dari 20 tungkai) dan adanya plak dengan spektrum Doppler yang masih normal di arteri-arteri ekstremitas bawah (100%, 20 dari 20 tungkai). Terdapat hubungaxi bermakna antara obesitas dan kejadian PAP (Rasio Odds = 22,45).
Kesimpulan: Dari penelitian ini, kami menyimpulkan bahwa: 1) UD dapat mendeteksi PAP pada penyandang DM tipe 2 dengan A131 normal; 2) Gambaran UD PAP pada pasien-pasien tersebut berupa penebalan KIM arteri femoralis dan adanya plak dengan spektnim Doppler normal di arteri-arteri ekstremitas bawah; 3) Obesitas merupakan karakteristik penyandang DM tipe 2 yang paling diprioritaskan untuk menjalani pemeriksaan UD.

Background: Peripheral arterial disease (PAD) is a manifestation of atherosclerosis disease, which commonly involves the non insulin dependent diabetes mellitus (NIDDM) patients. Ankle brachial index (A13I) test has been used as a screening test for PAD, but a normal ABI does not exclude PAD. Duplex ultrasonography (DU) is more sensitive but more expensive than ABI, so it is neccessaty to assess the characteristics q f NIDDM patiens who are mostly indicated to undergo DU examination.
Objectives: The objectives of this study are to prove that DU can detect PAD in NIDDM patients with normal ABI, to assess DU appearances of PAD, and to assess the characteristics of NIDDM patiens who are mostly indicated to undergo DU examination.
Materials and Methods: This study was conducted in a cross sectional design, which involved 40 legs. Every subject underwent ABI and DU examinations. Lower extremity arteries were examined, with assessment for femoral intitnal medial thickness (IMT), the presence of plaque, and evaluation of Doppler spectrum .1-or each artery. The risk factors were evaluated by anamnesis, physical examination and laboratory examination.
Results: From DU examination, as many as 50% (20 _ from 40 legs) are found to have PAD. The DU appearances q f PAD include increase_ femoral artery LMT (20%, 4 from 20 legs) and the presence of plaques with normal Doppler spectrums in the lower extremity arteries (100%, 20 from 20 legs). There was a significant relationship between obesity and the evidence of PAD (Odds ratio = 2 2, 45).
Conclusions: From this study, we conclude that: I) DU can detect PAD in NIDDM patients with normal ABI, 2) 7Tie DUI appearances of PAD in those patients include increase femoral arrey IMT and the presence of plaques with normal Doppler spectntras in the lower extremity arteries: 3) Obesity is the characteristic of NIDDM patients who are mostly indicated to undergo DU examination.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2006
T21426
UI - Tesis Membership  Universitas Indonesia Library
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Chandra Sari
"Latar Belakang. Prevalensi penyakit arteri perifer (PAP) pada pasien diabetes melitus lebih tinggi dibandingkan populasi umum. Penyakit arteri perifer dapat meningkatkan mortalitas dan morbiditas terutama akibat penyakit kardiovaskular pada pasien diabetes melitus tipe 2 (DM tipe 2). Tidak semua pasien dengan PAP dapat terdeteksi dengan pengukuran ankle brachial index (ABI) istirahat, sehingga diperlukan pemeriksaan ABI treadmill. Pemeriksaan ABI treadmill dapat mendeteksi PAP pada fase awal, sehingga profil pasien pada kelompok ini berbeda dengan klompok PAP yang dideteksi dengan ABI istirahat. Diketahuinya profil pasien PAP ini penting untuk membantu meningkatkan kewaspadaan pasien, khususnya pasien DM tipe 2.
Tujuan. Mengetahui profil pasien DM tipe 2 dengan PAP yang dideteksi dengan ABI treadmill.
Metode. Penelitian dengan desain potong lintang dilakukan di Poliklinik Metabolik Endokrin dan Kardiologi, Departemen Ilmu Penyakit Dalam, Rumah Sakit Cipto Mangunkusumo pada Februari sampai April 2016 dengan metode sampling konsekutif. Subjek dengan nilai ABI istirahat normal/ perbatasan menjalani treadmill dengan protokol Bruce yang digunakan juga sebagai protokol uji latih jantung treadmill. Diagnosis PAP ditegakkan bila terdapat penurunan nilai ABI lebih dari 20% dibandingkan ABI istirahat.
Hasil. Sebanyak 92 subjek dianalisis untuk mengetahui profil pasien DM tipe 2 dengan PAP yang dideteksi dengan ABI treadmill. Lima belas subjek (16,3%) didiagnosis PAP. Kelompok PAP memiliki persentase subjek dengan durasi diabetes ≥ 10 tahun sebanyak 53,3%; dislipidemia sebanyak 73,3%; penyakit ginjal kronik (PGK) sebanyak 33,3%; perokok sebanyak 40%; komplikasi neuropati sebanyak 53,3%; albuminuri sebanyak 53,3%; retinopati sebanyak 40%; dan respons iskemia jantung positif/sugestif positif sebanyak 40% subjek. Sedangkan kelompok tanpa PAP memiliki subjek dengan durasi diabetes ≥ 10 tahun sebanyak 33,8%; dislipidemia sebanyak 57,1%; PGK sebanyak 19,5%; perokok sebanyak 32,5%; komplikasi neuropati sebanyak 37,7%; albuminuri sebanyak 26,4%; retinopati sebanyak 28,6%; respons iskemia jantung positif/sugestif positif sebanyak 28,5% subjek.
Kesimpulan. Prevalensi PAP yang dideteksi dengan ABI treadmill pada pasien DM tipe 2 adalah 16,3% (IK 95%: 8-23%). Kelompok PAP yang dideteksi dengan ABI treadmill memiliki subjek dengan durasi DM ≥ 10 tahun, dislipidemia, perokok, PGK, neuropati, albuminuria, retinopati dan respons iskemia jantung positif/sugestif positif lebih banyak daripada subjek tanpa PAP.

Background. The prevalence of peripheral arterial disease (PAD) among diabetes patients was higher compared to general population. PAD increases morbidity and mortality, especially due to cardiovascular disease, in type 2 diabetes mellitus patients (T2DM). Not all patients having PAD could not be detected by resting ankle brachial index (ABI) measurement, hence it is required treadmill ABI examination. The examination enable to detect PAD in the earlier phase, therefore patients profile would different with PAD patient detected from resting ABI examination. The profiles are important to raise the awareness of T2DM patients.
Aim. To identify profile T2DM patients with PAD detected by treadmill ABI.
Methods. A cross-sectional study was carried out in Metabolic Endocrine and Cardiology Outpatient Clinic, Internal Medicine Department, Cipto Mangunkusumo Hospital during February-April 2016. The study used consecutive sampling method. Subject having normal or borderline resting ABI value is examine using Bruce protocol treadmill. The protocol is also used as a cardiac treadmill exercise test protocol. The patients diagnose as PAD if there is a reducing ABI value more than 20% compared to resting ABI.
Result. The profile of PAD patients detected by treadmill ABI were obtain from 92 subjects. Fifteen subjects (16,3%) were diagnosed having PAD. In the group with PAD, the percentage of subject with diabetes duration ≥ 10 years was 53,3%; dyslipidemia was 73.3%; chronic kidney disease (CKD) was 33.3%; smokers was 40%; complications of neuropathy was 53.3%; albuminuri was 53.3%; retinopathy was 40%; positive / positive suggestive cardiac ischemia response was 40% . Meanwhile the group without PAD, the percentage of subjects with diabetes duration ≥ 10 years was 33.8%; dyslipidemia was 57.1%; CKD was 19.5%; smokers was 32.5%; complications of neuropathy was 37.7%; albuminuri was 26.4%; retinopathy was 28.6%; positive / positive suggestive cardiac ischemia response was 28.5%.
Conclusion. The prevalence of PAD that detected by treadmilll ABI in T2DM patients is 16,3% (95% CI: 8-23%). The Group with PAD detected by ABI treadmill which have duration of diabetes ≥ 10 years, dyslipidemia, smokers, CKD, neuropathy, albuminuria, retinopathy, and the positive result on treadmill exercise test have more subjects than group without PAD.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
T55663
UI - Tugas Akhir  Universitas Indonesia Library
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Harbanu Hermawan Mariyono
"ABSTRAK
Latar Belakang: Aterosklerosis merupakan penyakit sistemik, bisa terjadi di seluruh pembuluh darah. Pada arteri karotis terjadi penebalan tunika intima yang dapat dideteksi menggunakan penunjang non invasif yaitu dengan ultasound. Pada tungkai dapat dilakukan pemeriksaan non invasif yaitu Ankle-Brachial Index (ABI) dan Toe-Brachial Index (TBI) untuk mengetahui adanya penyakit arteri perifer, dengan asumsi bahwa adanya penurunan ABI atau TBI menunjukkan sudah ada stenosis. Berdasarkan hal ini diduga terdapat hubungan antara ABI dan TBI dengan Carotid Intima Media Thickness (CIMT). Tujuan: Mendapatkan hubungan antara ABI dan TBI dengan CIMT. Metode: Dilakukan studi potong lintang pada 36 pasien diabetes tipe II. Dilakukan pemeriksaan ABI dan TBI bila memenuhi kriteria Penyakit Arteri Perifer, dilanjutkan dengan pemeriksaan ultrasound untuk mengetahui ketebalan tunika intima karotis. Hubungan antara ABI dan TBI dengan CIMT dihitung dengan Spearman. Hasil: Rerata ABI yang diperoleh adalah 0,97 ± 0,15, rerata TBI 0,56 ± 0,1. Nilai tengah CIMT 0,96 (0,77 - 3,60). Tidak terdapat hubungan antara ABI dengan CIMT (r=-259, p=0,127) dan terdapat hubungan negatif bermakna antara TBI dengan CIMT (r=-0,47, p=0,004). Simpulan: Tidak terdapat hubungan antara ABI dengan CIMT. Terdapat hubungan negatif bermakna antara TBI dengan CIMT.

ABSTRACT
Background: Atherosclerosis is a systemic disease that can be found in all arteries. Carotid Intima Media Thickness can be measure with ultrasound. Peripheral Artery Disease can be assessed with Ankle Brachial Index (ABI) And Toe Brachial Index (TBI). Low ABI or TBI can detect stenosis on the lower extremity arteries. Objective:To determine correlation between Ankle Brachial Index And Toe Brachial Index With Carotid Intima Media Thickness Methods: A cross sectional study on type II diabetic patients. Peripheral artery were assessed with Ankle Brachial Index and Toe Brachial Index. Carotid Intima Media Thickness measured with ultrasound. Correlation between ABI and TBI with CIMT were calculated with Spearman correlation test. Results: Mean Ankle Brachial Index were 0,97 ± 0,15, mean Toe Brachial Index 0,56 ± 0,1. Median of Carotid Intima Media Thickness 0,96 (0,77 - 3,60). Correlation between ABI with CIMT (r=-259, p=0,127) and TBI with CIMT (r=-0,47, p=0,004) Conclusions:There were no correlation between Ankle Brachial Index with Carotid Intima Media Thickness. There were negative correlation between Toe Brachial Index with Carotid Intima Media Thickness."
Depok: Fakultas Kedokteran Universitas Indonesia, 2019
T55532
UI - Tesis Membership  Universitas Indonesia Library
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Agis Taufik
"Diabetes Mellitus (DM) merupakan faktor risiko yang paling dominan menyebabkan Coronary Artery Disease (CAD). Pasien DM yang disertai dengan komplikasi CAD biasanya akan mengalami gejala Atypical angina. Gejala ini biasanya sangat sulit untuk dikenali sebagai nyeri angina yang khas pada pasien CAD, diperlukan pemeriksaan lebih lanjut untuk menegakkan diagnosis CAD. Ankle Brachial Index (ABI) merupakan indikasi adanya Peripheral Vascular Disease (PVD). PVD yang disertai neuropati dan infeksi pada pasien DM tipe 2 biasanya mengindikasikan adanya penyempitan pada pembuluh darah jantung.
Penelitian ini bertujuan untuk mengetahui bagaimana hubungan antara gangguan vaskuler perifer dengan gejala Atypical angina pada pasien DM tipe 2 yang memiliki komplikasi CAD. Desain penelitian ini menggunakan analitik korelasi dengan rancangan cross- sectional pada responden sebanyak 83 pasien. Hasil Anallisis menggunakan Chi- square didapatkan bahwa nilai ABI rendah (obstruksi) memiliki hubungan dengan gejala Atypical angina pada pasien DM tipe 2 yang memiliki komplikasi CAD (p: 0,02). Berdasarkan hasil penelitian ini, perawat perlu melakukan intervensi yang tepat guna mencegah te1jadinya komplikasi CAD pada pasien DM tipe 2.

Diabetes Mellitus is the most predominant risk factor that caused to coronary artery disease. Diabetes patient who are experiencing complication of coronary artery disease commonly experiencing atypical angina. These atypical angina symptoms usually difficult to identify, not like angina pain which is specific to coronary miery disease. Therefore it is needed further diagnostic examination to diagnose coronary artery disease. Ankle Brachial Index (ABI) can be used as one option in early diagnostic of peripheral vascular disease (PVD). PVD with neuropathies problem and infection on Diabetes type 2 patients commonly experience narrowing coronary blood vessels.
The purpose of this study was to examine the correlation between alterations on peripheral vascular with atypical angina on coronary artery disease patient with history of Diabetes Mellitus Type 2 who have complication of coronary artery disease. This is correlation analytic study using cross-sectional approach recruited 83 patients in the study. The result shows that the low ABI score when the patient experience obstructions, has significant correlation with atypical angina on DM patient type 2 who had CAD (p=0.02). It is suggested that nurses should implement nursing intervention that prevent complication of CAD on Diabetes patient type 2.
"
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2014
T41929
UI - Tesis Membership  Universitas Indonesia Library
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Muhammad Sahlan Zamaa
"[ABSTRAK
Diabetes melitus (DM) yang telah diderita selama bertahun-tahun dapat mengarah
ke berbagai komplikasi, diantaranya yaitu terjadinya peripheral arterial disease
(PAD). Salah satu indikator terjadinya PAD pada pasien DM tipe 2 yaitu adanya
penurunan nilai ankle brachial index (ABI) pada ekstremitas bawah pasien. Jika hal
ini terus dibiarkan, maka bisa terjadi neuropati yang dapat memicu munculnya
ulkus kaki diabetik. Intervensi yang dapat diberikan untuk meningkatkan nilai ABI
yaitu dengan melakukan foot massage atau latihan ROM ankle dorsofleksi. Tujuan
penelitian ini adalah untuk mengetahui efektivitas pemberian kombinasi foot
massage dan latihan ROM ankle dorsofleksi terhadap nilai ABI pada pasien DM
tipe 2. Penelitian ini merupakan penelitian quasi experiment dengan metode pre and
post test without control yang terdiri dari 2 kelompok intervensi dengan besar
sampel 20 responden. Hasil penelitian ini menunjukkan bahwa terdapat hubungan
yang signifikan antara pemberian kombinasi latihan ROM ankle dorsofleksi dan
foot massage terhadap peningkatan nilai ABI (p value = 0,033 untuk ekstremitas
kanan dan p value = 0,001 untuk ekstremitas kiri). Rekomendasi penelitian ini yaitu
agar para perawat dapat memberikan intervensi kombinasi latihan ROM ankle
dorsofleksi dan foot massage dalam rangka mencegah terjadinya PAD pada pasien
DM tipe 2.

ABSTRACT
The chronic diabetes mellitus has the potential to cause several complications
including peripheral arterial disease (PAD). A parameter indicating PAD amongst
Type 2 diabetes mellitus patients is the decline in the ankle brachial index (ABI) on
their lower extremity. Once this condition persists, it can cause neuropathy leading
to the occurrence of leg diabetic ulcer. An intervention believed to overcome this
problem is conducting foot massage or ankle dorsiflexion range of motion (ROM)
exercises. This research aimed at investigating the effectiveness of exercise
combination of foot massage and ankle dorsiflexion ROM on ABI scores among
type 2 diabetes mellitus patients. This study used quasi-experiment method with pre
and post-test without control design, and consisted two intervention groups
involving 20 participants. The study revealed that there was distinctive correlation
between the exercise combination of foot massage and ankle dorsiflexion ROM and
the increase of ABI scores of the patients (p value = 0.033 for the right extremities
and p value = 0.001 for the left extremities).The findings suggest that such
intervention can be considered or even be provided by nurses taking care of type 2
diabetes mellitus patients to prevent them from the possible deteriorating
complication, the peripheral artery disease.;The chronic diabetes mellitus has the potential to cause several complications
including peripheral arterial disease (PAD). A parameter indicating PAD amongst
Type 2 diabetes mellitus patients is the decline in the ankle brachial index (ABI) on
their lower extremity. Once this condition persists, it can cause neuropathy leading
to the occurrence of leg diabetic ulcer. An intervention believed to overcome this
problem is conducting foot massage or ankle dorsiflexion range of motion (ROM)
exercises. This research aimed at investigating the effectiveness of exercise
combination of foot massage and ankle dorsiflexion ROM on ABI scores among
type 2 diabetes mellitus patients. This study used quasi-experiment method with pre
and post-test without control design, and consisted two intervention groups
involving 20 participants. The study revealed that there was distinctive correlation
between the exercise combination of foot massage and ankle dorsiflexion ROM and
the increase of ABI scores of the patients (p value = 0.033 for the right extremities
and p value = 0.001 for the left extremities).The findings suggest that such
intervention can be considered or even be provided by nurses taking care of type 2
diabetes mellitus patients to prevent them from the possible deteriorating
complication, the peripheral artery disease., The chronic diabetes mellitus has the potential to cause several complications
including peripheral arterial disease (PAD). A parameter indicating PAD amongst
Type 2 diabetes mellitus patients is the decline in the ankle brachial index (ABI) on
their lower extremity. Once this condition persists, it can cause neuropathy leading
to the occurrence of leg diabetic ulcer. An intervention believed to overcome this
problem is conducting foot massage or ankle dorsiflexion range of motion (ROM)
exercises. This research aimed at investigating the effectiveness of exercise
combination of foot massage and ankle dorsiflexion ROM on ABI scores among
type 2 diabetes mellitus patients. This study used quasi-experiment method with pre
and post-test without control design, and consisted two intervention groups
involving 20 participants. The study revealed that there was distinctive correlation
between the exercise combination of foot massage and ankle dorsiflexion ROM and
the increase of ABI scores of the patients (p value = 0.033 for the right extremities
and p value = 0.001 for the left extremities).The findings suggest that such
intervention can be considered or even be provided by nurses taking care of type 2
diabetes mellitus patients to prevent them from the possible deteriorating
complication, the peripheral artery disease.]"
Depok: [Fakultas Ilmu Keperawatan Universitas Indonesia, ], 2014
T42662
UI - Tesis Membership  Universitas Indonesia Library
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Faisal Ali Ahmad Kler
"[ABSTRAK
Salah satu komplikasi dari Peripheral Arterial Disease (PAD) adalah kerusakan tungkai bawah hingga tidak
dapat digunakan untuk beraktifitas. PAD disebabkan oleh gangguan vaskular yang menyebabkan atherosklerotik
pada vaskular di bagian distal. Suatu penelitian kohort di Swedia menyatakan bahwa penyembuhan primer, laju
amputasi dan mortalitas pada pasien PAD berhubungan dengan derajat insufisiensi vaskular. Dengan demikian perlu dilakukan penelitian untuk mengetahui karakteristik vaskular pada kasus PAD secara kuantitatif maupun kualitatif serta hubungannya dengan nilai Ankle Brachial Index (ABI) dan gambaran gelombang Doppler Ultrasonography(DUS). Metode penelitian menggunakan studi potong lintang. Hasil penelitian didapatkan
pasien PAD dengan nilai ABI rata-rata 0,7 dengan gambaran gelombang DUS yang berubah dari trifasik
menjadi non-tirfasik dominan pada arteri infrapopliteal. ABI di bawah 0.9 menunjukkan perubahan pada gelombang DUS dari arteri femoralis hingga a.dorsalis pedis dengan nilai p <0.05. Faktor-faktor risiko yang paling tampak adalah usia di atas 45 tahun yang menunjukkan peningkatan risiko PAD. Selain itu hubungan
ABI dan faktor ?faktor risiko menunjukkan bahwa hiperlipidemia dan diabetes melitus menunjukkan hubungan signifikan dengan p<0,05. Sedang pada hubungan DUS dan faktor-faktor risiko hanya usia >45 tahun yang
tampak secara statistik signifikan meski secara klinis faktor-faktor risiko yang lain menunjukkan jumlah
persentase yang diatas 50%. Disimpulkan bahwa dengan mengetahui nilai ABI dapat ditentukan derajat
keparahan PAD dan juga dengan mengetahui gelombang DUS saja maka dapat diketahui oklusi di tingkat segmen arteri yang mana.Selain itu, usia di atas 45 tahun, hiperlipidemia dan juga diabetes melitus merupakan faktor risiko yang penting untuk terjadinya atherosklerosis dan penyumbatan pada distal arteri. Penggunaan DUS untuk menentukan tingkat penyumbatan sangat informatif dalam hal penggambran gelombang, aman dan murah sehingga dapat menetukan tindakan selanjutnya.ABSTRACT One of the complications of Peripheral Arterial Disease (PAD) is the damage that can be made to the lower
extremities causing difficulties to perform any activities with it. PAD is caused by vascular insufficiency known as atherosclerotic of the distal vascular. A cohort research in Sweden described that the primary recovery, amount of amputation and mortaltiy of PAD patients is related to the degree of vascular insufficiency. As for which, a research should be made to endorsed the knowhow of the vascular characteristics on PAD patients
quantitatively and qualitatively in accordance to ABI value and DUS spectral waveform. Methods used is cross
sectional. The result was, PAD patients had mean ABI value of 0.7 with changes of DUS spectral waveform
from triphasic to non-triphasic dominantly seen in infrapopliteal arteries. ABI less than 0.9 has a significant value towards changes in the spectral waveform from the femoral artery to the dorsal pedis artery. The risk factors such as age above 45 years old shows a significant relationship with the increase in PAD risk (p <0.05). Besides that, p <0.05 was also seen in hyperlipidemia and diabetes mellitus patients with PAD. As for the
relation between DUS and the risk factors, age above 45 years old was seen significant statistically eventhough
clinically all risk factors showed a percentage above 50%. It is concluded that by knowing the ABI value, the
degree of severity of PAD can be acknowledge and by knowing the waveform of DUS only one can know the
level of occlusion in an arterial segment. Besides that, age above 45 years, hyperlipidemia and diabetes mellitus are the important risk factors that causes atherosclerosis and occlusion in distal arteries. The usage of DUS to evaluate the level of occlusion is very informative showing images, it?s safe, low cost and can indicate towards future intervention. ;One of the complications of Peripheral Arterial Disease (PAD) is the damage that can be made to the lower
extremities causing difficulties to perform any activities with it. PAD is caused by vascular insufficiency known as atherosclerotic of the distal vascular. A cohort research in Sweden described that the primary recovery, amount of amputation and mortaltiy of PAD patients is related to the degree of vascular insufficiency. As for which, a research should be made to endorsed the knowhow of the vascular characteristics on PAD patients
quantitatively and qualitatively in accordance to ABI value and DUS spectral waveform. Methods used is cross
sectional. The result was, PAD patients had mean ABI value of 0.7 with changes of DUS spectral waveform
from triphasic to non-triphasic dominantly seen in infrapopliteal arteries. ABI less than 0.9 has a significant value towards changes in the spectral waveform from the femoral artery to the dorsal pedis artery. The risk factors such as age above 45 years old shows a significant relationship with the increase in PAD risk (p <0.05). Besides that, p <0.05 was also seen in hyperlipidemia and diabetes mellitus patients with PAD. As for the
relation between DUS and the risk factors, age above 45 years old was seen significant statistically eventhough
clinically all risk factors showed a percentage above 50%. It is concluded that by knowing the ABI value, the
degree of severity of PAD can be acknowledge and by knowing the waveform of DUS only one can know the
level of occlusion in an arterial segment. Besides that, age above 45 years, hyperlipidemia and diabetes mellitus are the important risk factors that causes atherosclerosis and occlusion in distal arteries. The usage of DUS to evaluate the level of occlusion is very informative showing images, it?s safe, low cost and can indicate towards future intervention. , One of the complications of Peripheral Arterial Disease (PAD) is the damage that can be made to the lower
extremities causing difficulties to perform any activities with it. PAD is caused by vascular insufficiency known as atherosclerotic of the distal vascular. A cohort research in Sweden described that the primary recovery, amount of amputation and mortaltiy of PAD patients is related to the degree of vascular insufficiency. As for which, a research should be made to endorsed the knowhow of the vascular characteristics on PAD patients
quantitatively and qualitatively in accordance to ABI value and DUS spectral waveform. Methods used is cross
sectional. The result was, PAD patients had mean ABI value of 0.7 with changes of DUS spectral waveform
from triphasic to non-triphasic dominantly seen in infrapopliteal arteries. ABI less than 0.9 has a significant value towards changes in the spectral waveform from the femoral artery to the dorsal pedis artery. The risk factors such as age above 45 years old shows a significant relationship with the increase in PAD risk (p <0.05). Besides that, p <0.05 was also seen in hyperlipidemia and diabetes mellitus patients with PAD. As for the
relation between DUS and the risk factors, age above 45 years old was seen significant statistically eventhough
clinically all risk factors showed a percentage above 50%. It is concluded that by knowing the ABI value, the
degree of severity of PAD can be acknowledge and by knowing the waveform of DUS only one can know the
level of occlusion in an arterial segment. Besides that, age above 45 years, hyperlipidemia and diabetes mellitus are the important risk factors that causes atherosclerosis and occlusion in distal arteries. The usage of DUS to evaluate the level of occlusion is very informative showing images, it’s safe, low cost and can indicate towards future intervention. ]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Sigit Mohammad Nuzul
"Tingginya prevalensi diabetes mellitus tipe 2 dan makanan khas daerah yang mengandung cukup banyak lemak menyebabkan peningkatan resiko peripheral arterial disease di Kota Palu. Latihan Buerger Allen merupakan salah satu cara mencegah dan mengatasi penyakit ini. Akan tetapi, latihan tersebut kurang digunakan karena belum adanya penelitian terkait latihan ini yang dipublikasikan di Indonesia. Penelitian ini bertujuan untuk mengetahui pengaruh latihan ini terhadap sirkulasi perifer pada ekstremitas bawah pasien diabetes mellitus tipe 2. Penelitian ini merupakan quasi-experimental, model pretest?posttest nonequivalent control group dengan 24 responden. Latihan ini diberikan kepada kelompok perlakuan selama 4 hari, 3 kali sehari, 2 siklus latihan selama 22 menit. Hasil uji statistik menunjukkan ada perbedaan bermakna nilai ankle brachial index antara pretest dan posttest pada kelompok perlakuan (p = .047; α .05), sebaliknya tidak ada perbedaan yang bermakna pada kelompok kontrol (p = .083; α .05). Secara statistik disimpulkan bahwa ada perbedaan bermakna antara nilai ankle brachial index posttest kelompok perlakuan dengan kontrol (p = .045; α .05), sehingga disimpulkan latihan ini efektif meningkatkan sirkulasi arteri perifer ekstremitas bawah. Disarankan agar latihan ini diberikan kepada pasien diabetes mellitus tipe 2.

Patient with diabetes mellitus have high risk of peripheral arterial disease. The risk increased on Palu City due to high prevalence of diabetes mellitus type 2 and food culture with high amount of fats. The Buerger-Allen exercise studies showed positive effect to improve lower extremity perfusion among patients with type 2 diabetes mellitus. However, this exercise gradually has been dropped in recent decades due to lack of published study in Indonesia. The study aimed to identify the effectiveness of this exercise to improve peripheral circulation of lower extremity. This study is the quasi-experimental with a pretest-posttest nonequivalent control group model, which enrolled 12 experimental and 12 control participants. Exercise had provided for 4 days, 3 times a day, and 2 cycles exercise for 22 minutes. The result showed significant difference of ankle-brachial index between the experiment and control group (p = .045; α .05). This study recommends Buerger-Allen exercise to be applied to patients with type 2 diabetes mellitus."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2016
S64606
UI - Skripsi Membership  Universitas Indonesia Library
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Fitri Astriana Lestari
"Diabetes melitus merupakan salah satu dari penyakit kronis penyebab kematian tertinggi di dunia. Kondisi hiperglikemia akan menyebabkan berbagai komplikasi baik akut maupun kronis mencakup komplikasi mikrovaskuler dan makrovaskuler. Salah satu diantaranya yang paling berbahaya yaitu munculnya peripheral arterial  disease (PAD) yang menyebabkan terjadinya foot ulcers. Penulisan karya tulis ilmiah ini bertujuan untuk menganalisis asuhan keperawatan pada pasien diabetes melitus serta efektivitas pemeriksaan ankle brachial index (ABI) dan senam kaki diabetes untuk mengatasi ketidakefektifan perfusi jaringan perifer. Pemeriksaan ABI dan senam kaki diabetes merupakan intervensi yang dapat digunakan untuk meningkatkan sirkulasi perifer dengan mengidentifikasi terjadinya gangguan pada sirkulasi perifer,  meningkatkan aliran kolateralisasi darah pada kaki dan meningkatkan fungsi insulin. Intervensi pemeriksaan ABI dan senam kaki diabetes dilakukan pada pasien diabetes melitus selama 7 hari perawatan. Hasilnya menunjukkan bahwa penerapan pemeriksaan ABI dan senam kaki diabetes dapat meningkatkan sirkulasi perifer dan mencegah timbulnya luka kaki. Melihat keefektifan pemeriksaan ABI dan senam kaki diabetes untuk meningkatkan sirkulasi perifer maka diharapkan intervensi ini dapat digunakan sebagai perawatan rutin pada pasien diabetes melitus.


Diabetes mellitus is one of the highest chronic disease causes of death in the world. The condition of hyperglycemia will cause various complications either acute and chronic including microvascular and macrovascular complications. One of the most dangerous is the emergence of peripheral arterial disease (PAD) which causes foot ulcer. The scientific paper aims to analyze nursing care in patient with diabetes mellitus and the effectiveness of measuring the ankle brachial index (ABI) and diabetic foot exercises to overcome the ineffectiveness of peripheral tissue perfusion. The examination of ABI and diabetic foot exercises are interventions that can be used to improve peripheral circulation by identifying disturbances in peripheral circulation, increasing the flow of blood collateralisation in the foot and improving insulin function. Intervention of ABI examination and diabetic foot exercises were carried out in patient with diabetes mellitus for 7 days treatment. The results show that the application of ABI examination and diabetic foot exercises can improve peripheral circulation and prevent foot injuries. Reviewing the effectiveness of ABI examination and diabetic foot exercises to improve peripheral circulation, then it is hoped that this interventions can be used as a routine treatment in patients with diabetes mellitus."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2020
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Lisa Safitri
"Latar Belakang: Prevalensi penyakit arteri perifer PAP pada pasien dengan penyakit ginjal kronik PGK terlihat meningkat sejak stadium 3. Alat diagnostik nilai indeks ankle brachial ABI cukup akurat dalam mendeteksi PAP pada populasi normal. Pada PGK yang sering terjadi kalsifikasi pembuluh darah dimana nilai ABI dapat menjadi normal atau tinggi meski sudah ada stenosis pembuluh darah. Kalsifikasi pada ibu jari jarang terjadi membuat pemeriksaan nilai indeks toe brachial TBI mempunyai kelebihan dalam menilai PAP pada PGK.
Tujuan: Untuk mendapatkan proporsi PAP berdasarkan nilai ABI dan TBI serta informasi mengenai profil PAP pada PGK predialisis dan faktor yang diduga berhubungan.
Metode: Penelitian potong lintang pada pasien PGK di poliklinik Ilmu Penyakit Dalam, poliklinik Ginjal Hipertensi, poliklinik Kardiologi dan poliklinik Kardiologi Pusat Jantung Terpadu RSCM periode Oktober 2015-Maret 2016. Data didapatkan dari hasil wawancara, pemeriksaan fisik, nilai ABI dan TBI, serta pemeriksaan laboratorium. Studi deskriptif dilakukan dengan melihat proporsi PAP berdasarkan nilai ABI dan TBI, proporsi variabel dan penentuan nilai rerata dan median.
Hasil: Terdapat 75 pasien yang memenuhi kriteria penelitian. Proporsi PAP berdasarkan nilai ABI dan TBI 60 IK 95 49 -; 71. Nilai ABI. 0,9 dan TBI. 0,7 digunakan sebagai cut off dalam diagnosis PAP. Proporsi PAP pada tiap stadium ginjal mulai terlihat besar. Pasien dengan PAP lebih banyak laki-laki 51,1 dan rerata IMT 23,57 3,5 kg/m2. Median usia pasien 64 tahun 33-74 tahun. Nilai median ABI 1,04 0,7-1,26 dan TBI 0,61 0,31-0,74. Sebagian besar tidak merokok 53,3, mempunyai komorbiditas hipertensi 84, diabetes melitus 64, penyakit jantung koroner 57 dan dislipidemia 40. Nilai median laju filtrasi glomerulus 31,6 6,3-57,6, nilai median albuminuria 153 mg/g kreatinin 7,9-10767,3, nilai median kalsium. mg/dL 7,2-9,8 mg/dL, nilai median fosfat 3,9 mg/dL 1,9-5,7 mg/dL, rerata nilai produk CaxPO4 33,7 6,5 mg2/dL2 dan nilai median hsCRP 1,3 mg/L 0,1-19,19 mg/L. Proporsi pasien dengan hipertensi lebih besar pada pasien dengan PAP. Sementara proporsi DM tidak terkontrol lebih besar dibandingkan yang terkontrol 44. 20.
Simpulan: Proporsi PAP pada pasien PGK predialisis berdasarkan nilai ABI dan TBI sebesar 60. PAP pada PGK predialisis lebih banyak pada subjek dengan komorbiditas, diabetes melitus yang tidak terkontrol, stadium. klasifikasi Fontaine dan kecenderungan albuminuria yang meningkat.

Background The prevalence of peripheral artery disease PAD in chronic kidney disease patients is increasing in CKD stage. or higher. Ankle brachial index is an accurate diagnostic tool in population without CKD. Higher prevalence of arterial calcification in CKD can lead to. normal or high ABI in stenotic vessel. Toe vessels are less susceptible to calcification, therefore toe brachial index TBI measurement can be more useful for PAD assessment in CKD population.
Objectives: The aim of the study is to determine the profile of PAD based on ankle brachial index and toe brachial index in predialysis CKD patients.
Methods: cross sectional study was conducted in outpatient clinics of Dr. Cipto Mangunkusumo hospital from October 2015 to March 2016. The data were obtained by interview, ABI and TBI measurement, and analyzing the laboratories values.
Results: In 75 patients ABI and TBI measurement were conducted simultaneously. ABI 0.9 and or TBI 0.7 had been used as cut off values for diagnosing PAD. PAD proportion based on ABI and TBI in CKD predialysis is 60 IK 95 49 - 71. PAD proportion in every CKD stage are high. Most of the subject are male 51.1 and the mean body mass index value is 23.57 3.5 kg m2. The age median is 64 year old 33 74 year old. The median value of ABI is 1.04 0.7 1.26 and TBI 0.61 0.31 0.74. Most of the patients are non smoker 53.3, had hypertension 84, diabetic 64, coronary artery disease 57 and dyslipidemia 40. Median value of glomerulus filtration rate is 31.6 ml menit 1.73 m2 6.3 57.6 ml menit 1.73 m2, median value of albuminuria 153 mg. kreatinin 7.9 10767.3 median value of calcium. mg dL 7.2 9.8 mg dL, median value of phosphate 3.9 mg dL 1.9 5.7 mg dL, mean value of CaxPO4 product is 33.7 6.5 mg2 dL2 and median value of hsCRP 1.3 mg. 0.1 19.19 mg.. Most patient with PAD had. greater proportion of hypertension. The proportion of uncontrolled diabetes are higher in patient with PAD 44 vs 20.
Conclusion PAD proportion based on ABI and TBI is 60 IK 95 49 - 71. Most of the patients with PAD in CKD predialyis are with uncontrolled diabetes, stage II of Fontaine classification, increased albuminuria.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
T55632
UI - Tesis Membership  Universitas Indonesia Library