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Reactive Protein Dan Glutamat Serum Dengan Intensitas Nyeri Setelah Pemberian Flunarizin Pada Penderita Tension-Type Headache Kronik

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Reactive Protein Dan Glutamat Serum Dengan Intensitas Nyeri Setelah Pemberian Flunarizin Pada Penderita Tension-Type Headache Kronik KORELASI MATRIKS METALLOPROTEINASE-9, HIGH SENSITIVITY C- REACTIVE PROTEIN DAN GLUTAMAT SERUM DENGAN INTENSITAS NYERI SETELAH PEMBERIAN FLUNARIZIN PADA PENDERITA TENSION-TYPE HEADACHE KRONIK DISERTASI KHAIRUL PUTRA SURBAKTI NIM 128102001 PROGRAM STUDI DOKTOR (S-3) ILMU KEDOKTERAN FAKULTAS KEDOKTERAN UNIVERSITAS SUMATERA UTARA MEDAN 2018 i UNIVERSITAS SUMATERA UTARA KORELASI MATRIKS METALLOPROTEINASE-9, HIGH SENSITIVITY C- REACTIVE PROTEIN DAN GLUTAMAT SERUM DENGAN INTENSITAS NYERI SETELAH PEMBERIAN FLUNARIZIN PADA PENDERITA TENSION TYPE HEADACHE KRONIK DISERTASI Diajukan sebagai Salah Satu Syarat untuk Memperoleh Gelar Doktor dalam Program Studi Doktor (S-3) Ilmu Kedokteran pada Kakultas Kedokteran Universitas Sumatera Utara Untuk dipertahankan di hadapan Sidang Ujian Terbuka Program Studi Doktor (S-3) Ilmu Kedokteran Universitas Sumatera Utara Oleh KHAIRUL PUTRA SURBAKTI 128102001 PROGRAM STUDI DOKTOR (S-3) ILMU KEDOKTERAN UNIVERSITAS FAKULTAS KEDOKTERAN UNIVERSITAS SUMATERA UTARA MEDAN 2018 ii UNIVERSITAS SUMATERA UTARA PROMOTOR Prof. Dr. dr. Hasan Sjahrir, Sp.S(K) Guru Besar Neurologi Fakultas Kedokteran Universitas Sumatera Utara Medan KO-PROMOTOR Dr. dr. Rosita Juwita Sembiring, Sp.PK Staf Pengajar Program Studi Doktor (S-3) Ilmu Kedokteran Fakultas Kedokteran Universitas Sumatera Utara Medan KO-PROMOTOR Dr. Ir. Erna Mutiara, MKM Staf Pengajar Biostatistika dan Informasi Kesehatan Fakultas Kesehatan Masyarakat Universitas Sumatera Utara Medan iii UNIVERSITAS SUMATERA UTARA Judul Disertasi : Korelasi Matriks Metalloproteinase-9, High Sensitivity C- Reactive Protein dan Glutamat Serum dengan Intensitas Nyeri setelah Pemberian Flunarizin pada Penderita Tension- Type Headache Kronik Nama Mahasiswa : Khairul Putra Surbakti NIM : 128102001 Program Studi : Doktor (S-3) Ilmu Kedokteran Menyetujui: Komisi Pembimbing Prof. Dr. dr. Hasan Sjahrir, Sp.S(K) Promotor Dr. dr. Rosita Juwita Sembiring, Sp.PK Ko-Promotor I Dr. Ir. Erna Mutiara, MKM Ko-Promotor II Ketua Program Studi Doktor (S-3) Dekan Fakultas Kedokteran USU Prof.Dr.dr. Delfitri Munir, Sp.THT-KL(K) Dr.dr. Aldy Safruddin Rambe, Sp.S(K) iv UNIVERSITAS SUMATERA UTARA Telah diuji pada Ujian Tertutup Pada tanggal 17 Mei 2017 TIM PENGUJI DISERTASI Ketua : Prof. Dr. dr. Hasan Sjahrir, Sp.S(K) Anggota : Dr. dr. Rosita Juwita Sembiring, Sp.PK Dr. Ir. Erna Mutiara, MKM Prof. dr. Aznan Lelo, Ph.D, Sp.F(K) Prof. dr. H. M. Nadjib Dahlan, Sp.PK(K) Dr. dr. Endang Mutiawati R, Sp.S(K) Dr. dr. Aldy Safruddin Rambe, Sp.S(K) v UNIVERSITAS SUMATERA UTARA PERNYATAAN PERSETUJUAN PUBLIKASI KARYA ILMIAH UNTUK KEPENTINGAN AKADEMIS Sebagai civitas akademik Universitas Sumatera Ytara, saya yang bertanda tangan dibawah ini: Nama : Khairul Putra Surbakti N I M : 128102001 Program Studi : Ilmu Kedokteran Jenis karya : Disertasi Demi pengembangan ilmu pengetahuan, menyetujui untuk memberikan kepada Universitas Sumatera Utara Hak Bebas Royalty Non-Eksklusif (Non-Exclusive Royalty Free Right) atas disertasi saya yang berjudul : Korelasi Matriks Metalloproteinase-9, High Sensitivity C- Reactive Protein dan Glutamat Serum dengan Intensitas Nyeri setelah Pemberian Flunarizin pada Penderita Tension-Type Headache Kronik beserta perangkat yang ada (jika diperlukan). Dengan Hak Bebas Royalty Non- Eksklusif ini Universitas Sumatera Utara berhak menyimpan, mengalih media/formatkan, mengelola dalam bentuk database, merawat, dan mempublikasikan disertasi saya tanpa meminta izin dari saya sebagai penulis dan pemilik hak cipta. Demikian pernyataan ini saya perbuat dengan sebenarnya. Dibuat di Medan Pada tanggal 9 Desember 2017 Yang menyatakan, Khairul Putra Surbakti vi UNIVERSITAS SUMATERA UTARA UCAPAN TERIMA KASIH Bismillahirrahmanirrahim Assalamualaikum Warahmatullahi Wabarakatuh Puji syukur ke hadirat Allah SWT yang Maha Pengasih dan Maha Penyayang, atas segala rahmat dan karunia-Nya, promovendus dapat melaksanakan pendidikan S-3 Ilmu Kedokteran. Alhamdulillah promovendus dapat menyelesaikan disertasi dengan judul: “Korelasi Matriks Metalloporoteinase-9, High Sensitivity C-Reactive Protein dan Glutamat Serum dengan Intensitas Nyeri setelah Pemberian Flunarizin pada Tension-Type Headache Kronik”. Penelitian dan penulisan desertasi ini mendapat dukungan dari berbagai pihak. Dengan hati yang tulus, promovendus mengucapkan terima kasih dan penghargaan kepada yang terhormat Rektor Universitas Sumatera Utara, Prof. Dr. Runtung Sitepu, SH, M.Hum, Rektor sebelumnya, Prof. Dr. dr. Syahril Pasaribu, DTM&H, M.Sc(CTM), Sp.A(K), Dekan Fakultas Kedokteran Universitas Sumatera Utara Dr. dr. Aldy Safruddin Rambe, Sp.S(K) dan Dekan sebelumnya Prof. Dr. Gontar A. Siregar, Sp.PD-KGEH, Ketua Departemen Neurologi FK-USU dr. Rusli Dhanu, Sp.S(K), Mantan Ketua Program Studi doktor (S-3) Ilmu Kedokteran Prof. dr. Chairuddin P. Lubis, DTM&H, SpA(K) dan Ketua Program Studi S-3, Prof. Dr. dr. Delfitri Munir, Sp.THT-KL(K) atas kesempatan dan fasilitas yang diberikan kepada promovendus untuk mengikuti dan menyelesaikan pendidikan Program Studi Doktor (S-3) Ilmu Kedokteran di Fakultas Kedokteran Universitas Sumatera Utara. Ucapan terima kasih dan penghargaan setinggi-tingginya promovendus sampaikan kepada Promotor dan Ko-promotor: Prof. Dr. dr. Hasan Sjahrir, Sp.S(K), Dr. dr. Rosita Juwita Sembiring, Sp.PK dan Dr. Ir. Erna Mutiara, MKM yang telah memberikan arahan dan motivasi dalam perencanaan dan pelaksanaan penelitian ini sejak awal hingga selesainya penelitian dan penulisan disertasi ini. Semoga Allah vii UNIVERSITAS SUMATERA UTARA SWT selalu melimpahkan rahmat dan karunia-Nya serta kesehatan kepada beliau bertiga. Selanjutnya, promovendus juga mengucapkan terima kasih dan salam hormat kepada tim penguji disertasi Prof. dr. Aznan Lelo, Ph.D, Sp.F(K), Prof. dr. H.M. Nadjib Dahlan, Sp.PA(K), Dr. dr. Endang Mutiawati R, Sp.S(K), Dr. dr. Aldy Safruddin Rambe, Sp.S(K) atas segala bimbingan dan koreksi terhadap disertasi ini selama proses persiapan penelitian hingga penulisan disertasi ini. Ucapan terima kasih dan penghargaan setinggi tingginya promovendus ucapkan kepada seluruh staf pengajar di lingkungan Program Studi S-3 Ilmu Kedokteran FK-USU:Prof. dr. Chairuddin P. Lubis, DTM&H, SpA(K), Prof. dr.Harun Rasyid Lubis, Sp.PD-KGH, Alm. Prof. dr. Iskandar Zulkarnain Lubis, Sp.A(K), Prof. Dr. Ir. Sumono MS, Drs. Sutarman, Msi, PhD, Dr. Drs. Ridwan Siregar, M.Lib, dr. Adang Bachtiar, MPH, DSc, Prof Dr. Ir. Harmein Nasution, MSIE, Dr. dr. Rosita Juwita Sembiring, Sp.PK saya ucapkan terima kasih atas bimbingan dan diskusinya selama saya mengikuti Program Studi S-3. Ucapan terima kasih promovendus sampaikan kepada Guru-guru beserta seluruh staf Departemen Neurologi FK-USU, Alm. dr. H. H. Rambe Sp.S(K), Alm. Prof. dr. Darulkutni Nasution, Sp.S(K), Alm. dr. Syawaluddin Nasution, Sp.S(K), Prof. Dr. dr. Hasan Sjahrir, Sp.S(K), Alm. dr. Syukri Batubara, Sp.S(K), Alm. dr. L.B.M. Sitorus, Sp.S, dr. Darlan Djali Chan, Sp.S, dr. Rusli Dhanu, Sp.S(K), dr. Yuneldi Anwar, Sp.S(K), Dr. dr. Aldy Safruddin Rambe, Sp.S(K), Dr. dr. Kiking Ritarwan, MKT, Sp.S(K), dr. Puji P.O. Sinurat, SpS(K), dr. Cut Aria Arina, Sp.S, dr. Kiki M Iqbal, Sp.S, dr. Alfansuri Kadri, Sp.S, dr. Aida Fitri, Sp.S(K), dr. Irina Kemala Nasution, Mked(Neu), Sp.S, dr. Haflin S Hutagalung, Mked(Neu), Sp.S, dr. Fasihah Irfani Fitri, Mked(Neu), Sp.S, dr. Iskandar Nasution, Sp.S, FINS, dr.R.A. Dwi Pujiastuti, Mked(Neu), Sp.S, dr. Chairil Amin Batubara, Mked(Neu), Sp.S dan dr M. Yusuf, Sp.S, FINS serta seluruh peserta didik PPDS-I dan pegawai viii UNIVERSITAS SUMATERA UTARA administrasi Departemen Neurologi FK-USU atas semua bantuan, pengertian serta dukungan moril sehingga promovendus dapat menyelesaikan program S-3 ini. Ucapan terima kasih promovendus sampaikan kepada Direktur RSUP H. Adam Malik Medan, Kepala Rumkit Putri Hijau Medan, Kepala Dinas Kesehatan Kota Medan dan Kepala Puskesmas Medan Johor Medan yang telah memberikan izin untuk melakukan penelitian dalam rangka penulisan disertasi ini. Terima kasih juga disampaikan kepada Pimpinan dan Staf Laboratorium Patologi Klinik RSUP. H. Adam Malik Medan yang telah memfasilitasi pemeriksaan MMP-9, hs-CRP dan Glutamat serum selama penelitian ini. Ucapan terima kasih semua pihak yang telah bersedia menjadi subjek penelitian ini, semoga budi baik Ibu Bapak mendapat balasan dari Allah SWT. Ucapan yang sama promovendus sampaikan kepada Drs. Abdul Djalil Amri Amra, M.Kes dan Dr. Ir. Erna Mutiara, MKM atas bimbingan dan bantuan saat penulis mengerjakan statistik penelitian ini. Promovendus juga menyampaikan ucapan terima kasih kepada Dr. dr. Imam Budi Putra, MHA, Sp.KK dan Sekretaris Program Studi Doktor (S-3) Dr. dr. Iqbal Pahlevi Adeputra Nasution, Sp.BA(K) serta Petty Angelia H, SS, Dewi Andani, S.Kom dan Erna Kusuma pegawai administrasi Program Studi Doktor (S-3) Ilmu Kedokteran atas bantuan dan kerjasama yang diberikan selama ini serta seluruh peserta Program Studi Doktor (S-3) FK-USU baik yang sudah selesai maupun yang sedang mengikuti pendidikan, yang telah membantu dalam proses pendidikan dan hubungan baik yang tercipta selama ini. Kepada kedua orang tua saya Lettu. Inf. Abdul Rahim Surbakti (alm) dan ibunda Hj Chairiah (alm), yang telah melahirkan, membesarkan dan mengasuh dengan kasih sayang sejak kecil, mendidik serta membimbing dan memberi tauladan dalam bekerja keras, memberikan pendidikan ilmu pengetahuan dan agama islam, saling menyayangi sesama saudara dan umat, bertanggung jawab atas tugas yang ix UNIVERSITAS SUMATERA UTARA diembankan serta tabah dalam menjalani kehidupan, ananda senantiasa mendoakan semoga Allah SWT menempatkan disisi-Nya
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