KARYA TULIS AKHIR

PENGARUH PEMBERIAN EKSTRAK BUNGA TURI MERAH (Sesbania

grandiflora (L.) Pers) TERHADAP GAMBARAN HISTOPATOLOGI

GINJAL TIKUS PUTIH JANTAN (Rattus norvegicus strain wistar)

HIPERKOLESTEROLEMIA

Oleh:

PUTRI DERY CAHYANI

201210330311135

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2016

HASIL PENELITIAN

PENGARUH PEMBERIAN EKSTRAK BUNGA TURI MERAH (Sesbania

grandiflora (L.) Pers) TERHADAP GAMBARAN HISTOPATOLOGI

GINJAL TIKUS PUTIH JANTAN (Rattus norvegicus strain wistar)

HIPERKOLESTEROLEMIA

KARYA TULIS AKHIR

Diajukan Kepada

Universitas Muhammadiyah Malang

untuk Memenuhi Salah Satu Persyaratan

dalam Menyelesaikan Program Sarjana

Fakultas Kedokteran

Oleh:

PUTRI DERY CAHYANI

201210330311135

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2016

LEMBAR PENGESAHAN

LAPORAN HASIL PENELITIAN

Telah disetujui sebagai hasil penelitian untuk memenuhi persyaratan pendidikan

sarjana Fakultas Kedokteran

Universitas Muhammadiyah Malang

Tanggal : 27 Agustus 2016

Pembimbing I

dr. Sulistyo Mulyo Agustini, Sp.PK

Pembimbing II

dr. Halida Nelasari, Sp.OG

Mengetahui,

Fakultas Kedokteran Universitas Muhammadiyah Malang

Dekan,

dr. Irma Suswati, M.Kes

LEMBAR PENGUJIAN

Karya Tulis Akhir oleh Putri Dery Cahyani ini

telah diuji dan dipertahankan di depan Tim Penguji

pada tanggal 27 Agustus 2016

Tim Penguji

dr. Sulistyo Mulyo Agustini, Sp.PK , Ketua

dr. Halida Nelasari, Sp.OG , Anggota

dr. Alfa Sylvestris, Sp.M , Anggota

KATA PENGANTAR

Alhamdulillahhirabil’alamin, puji syukur kehadirat Allah SWT yang telah

melimpahkan karunia-Nya sehingga penulis dapat menyelesaikan karya tulis akhir

yang berjudul “Pengaruh Pemberian Ekstrak Bunga Turi Merah (Sesbania

grandiflora (L.) Pers) Terhadap Gambaran Histopatologi Ginjal Tikus Putih

Jantan (Rattus norvegicus strain wistar) Hiperkolesterolemia”.

Karya tulis ini disusun sebagai satu persyaratan dalam menyelesaikan

Program Sarjana Kedokteran S1 (Strata 1). Dalam kesempatan ini penulis

menyampaikan terima kasih yang setulusnya kepada pihak yang telah mendukung

penyelesaian Karya Tulis Akhir ini, terutama kepada:

1. Allah SWT, karena dengan pertolongan-Nya penulis bisa melewati

kesulitan dalam menyelesaikan karya tulis akhir ini.

2. dr. Irma Suswati, M.Kes, selaku Dekan Fakultas Kedokteran

Universitas Muhammadiyah Malang.

3. dr. Sulistyo Mulyo Agustini, Sp.PK, selaku Pembimbing I yang telah

meluangkan waktu serta dengan penuh kesabaran telah membimbing,

memberi saran dan semangat kepada penulis dalam menyelesaikan

karya tulis akhir ini.

4. dr. Halida Nelasari, Sp.OG, selaku Pembimbing II yang telah

meluangkan waktu untuk membimbing, mengoreksi, memberikan

informasi dan semangat kepada penulis dalam menyelesaikan karya

tulis akhir ini.

5. dr. Alfa Sylvestris, Sp.M, selaku Penguji yang telah memberikan

informasi, kritik dan saran serta motivasi dalam menyelesaikan karya

tulis akhir ini.

6. dr. Dian Yuliartha Lestari, Sp.PA yang telah membimbing serta

memberikan informasi dalam penelitian yang penulis lakukan.

7. Seluruh Dosen Fakultas Kedokteran Universitas Muhammadiyah

Malang yang telah memberikan ilmu dan dukungan kepada penulis

dalam menyelesaikan studi

8. Orang tua tercinta, Ibu Fahdilatun dan Bapak Sugeng, yang setiap hari

tak henti-hentinya memberikan dukungan, doa di setiap sholat,

semangat, cinta dan kasih sayang sehingga penulis bersemangat untuk

segera menyelesaikan karya tulis akhir ini.

9. Adik-adik tersayang, Imam Nugroho dan Arifani yang tak henti-

hentinya memberikan semangat kepada penulis.

10. Sahabat-sahabat Laras Hidayati, Rifqi Adzani, Dwi Anggi, Izmi Ika,

Wildan, Darma Aswandi yang telah memberikan semangat dan doa

agar penulis segera menyusul segera bergelar di belakang nama.

11. Turi Merah Squad: Mamah Dita, Milla, Galih, Lena yang telah

bekerja sama dan saling membantu dalam menyelesaikan penelitian,

teman-teman yang juga membantu dalam penelitian: Radityo, Tegar

dan Riko.

12. Teman-teman angkatan 2012 “Abdomen” FK UMM, terima kasih atas

semangat dan dukungannya serta kekeluargaannya.

13. Staf Tata Usaha FK UMM yang telah banyak membantu penulis

mengurus keperluan tugas akhir.

14. Pak Joko dan Mas Miftah yang telah banyak membantu penulis dalam

menyelesaikan penelitian dan bersedia dimintai tolong ketika penulis

mengalami kendala dalam penelitian.

15. Semua pihak yang telah membantu penulis dalam penyusunan dan

penyelesaian karya tulis akhir, yang tidak dapat disebutkan satu

persatu.

Penulis menyadari bahwa penelitian ini masih jauh dari sempurna, oleh

karena itu penulis mengharapkan masukan dari berbagai pihak. Semoga penelitian

ini dapat bermanfaat bagi penulis dan berbagai pihak.

Malang, Agustus 2016

Penulis

DAFTAR ISI

Halaman

HALAMAN JUDUL .............................................................................. i

LEMBAR PENGESAHAN ................................................................... ii

LEMBAR PENGUJI .............................................................................. iii

KATA PENGANTAR ........................................................................... iv

ABSTRAK ............................................................................................. vii

ABSTRACT ............................................................................................. viii

DAFTAR ISI .......................................................................................... ix

DAFTAR TABEL ................................................................................... xiii

DAFTAR GAMBAR .............................................................................. xiv

DAFTAR SINGKATAN ........................................................................ xv

BAB 1 PENDAHULUAN .................................................................... 1

1.1 Latar Belakang ................................................................... 1

1.2 Rumusan Masalah .............................................................. 2

1.3 Tujuan Penelitian ............................................................... 2

1.3.1 Tujuan Umum ........................................................... 2

1.3.2 Tujuan Khusus .......................................................... 2

1.4 Manfaat Penelitian ............................................................. 3

1.4.1 Akademik ................................................................. 3

1.4.2 Klinis ........................................................................ 3

1.4.3 Masyarakat ............................................................... 3

BAB 2 TINJAUAN PUSTAKA ........................................................... 4

2.1 Hiperkolesterolemia ........................................................... 4

2.1.1 Metabolisme Lemak ................................................. 4

2.1.2 Transport Lipid ......................................................... 4

2.1.3 Kolesterol ................................................................. 5

2.1.4 Pembentukan dan Fungsi Lipoprotein ...................... 6

2.1.5 LDL Teroksidasi ....................................................... 7

2.1.6 Kerusakan Endotel ................................................... 8

2.1.7 Mekanisme Hiperkolesterolemia .............................. 9

2.2 Ginjal ................................................................................. 10

2.2.1 Anatomi Ginjal Manusia .......................................... 10

2.2.2 Fisiologi dan Histologi Ginjal Manusia ................... 12

2.2.3 Anatomi Ginjal Tikus ............................................... 14

2.2.4 Fisiologi dan Histologi Ginjal Tikus ........................ 15

2.2.5 Histopatologi Ginjal pada Tikus Hiperkolesterolemia 16

2.2.6 Perbedaan Ginjal Tikus dan Manusia ....................... 18

2.3 Bunga Turi ......................................................................... 19

2.3.1 Taksonomi ................................................................ 19

2.3.2 Morfologi Tanaman .................................................. 20

2.3.3 Manfaat Bunga Turi ................................................. 21

2.3.4 Kandungan Bunga Turi ............................................ 22

2.3.5 Bunga Turi Merah sebagai Antioksidan ................... 24

2.3.6 Mekanisme Bunga Turi sebagai Antioksidan .......... 24

BAB 3 KERANGKA KONSEP DAN HIPOTESIS ............................. 27

3.1 Kerangka Konsep ............................................................... 27

3.2 Hipotesis ............................................................................ 29

BAB 4 METODE PENELITIAN.......................................................... 30

4.1 Rancangan Penelitian ......................................................... 30

4.2 Tempat dan Waktu Penelitian ............................................ 30

4.3 Populasi dan Sampel .......................................................... 30

4.3.1 Populasi .................................................................... 30

4.3.2 Sampel ...................................................................... 30

4.3.3 Estimasi Besar Sampel ............................................. 30

4.3.4 Tehnik Pengambilan Sampel .................................... 32

4.3.5 Karakteristik Sampel Penelitian ............................... 32

4.3.6 Variabel Penelitian ................................................... 32

4.3.6.1 Variabel Bebas ........................................... 32

4.3.6.2 Variabel Tergantung ................................... 33

4.3.7 Definisi Operasional ................................................. 33

4.4 Diet Hiperkolesterol ........................................................... 34

4.5 Dasar Penentuan Dosis Bunga Turi Merah ........................ 34

4.6 Alat dan Bahan Penelitian .................................................. 36

4.6.1 Alat dan Bahan Pemeliharaan Tikus ........................ 36

4.6.2 Alat dan Bahan Bedah Tikus .................................... 36

4.6.3 Alat dan Bahan Pembuatan Ekstrak Bunga Turi ...... 36

4.6.4 Bahan Pembiusan Tikus ........................................... 36

4.6.5 Alat Lain ................................................................... 37

4.7 Prosedur Penelitian ............................................................ 37

4.7.1 Pembagian Kelompok Tikus .................................... 37

4.7.2 Adaptasi Hewan Percobaan ...................................... 38

4.7.3 Pemberian Diet Tinggi Lemak ................................. 38

4.7.4 Cara Pembuatan Ekstrak Bunga Turi Merah ............ 38

4.7.5 Pemberian Ekstrak Bunga Turi Merah ..................... 39

4.7.6 Proses Anestesi dan Pembedahan Hewan Coba ....... 39

4.7.7 Pembuatan Sediaan Histopatologi ............................ 40

4.8 Alur Penelitian ................................................................... 42

4.9 Analisa Data ....................................................................... 43

BAB 5 HASIL PENELITIAN DAN ANALISA DATA ..................... 44

5.1 Hasil Penelitian ................................................................. 44

5.2 Analisa Data ...................................................................... 48

5.2.1 Uji Kruskal-Wallis .................................................. 48

5.2.2 Uji Mann-Whitney .................................................. 48

5.2.3 Uji Korelasi Spearman ............................................ 50

BAB 6 PEMBAHASAN ...................................................................... 51

BAB 7 KESIMPULAN DAN SARAN ................................................ 59

7.1 Kesimpulan ....................................................................... 59

7.2 Saran ................................................................................. 59

DAFTAR PUSTAKA ............................................................................. 60

LAMPIRAN ........................................................................................... 67

DAFTAR TABEL

Tabel Halaman

2.1 Perbedaan Ginjal Tikus dan Manusia ....................................... 19

2.2 Komponen Gizi Bunga Turi Merah per 100 g .......................... 23

2.3 Komponen Zat Non Gizi Bunga Turi Merah per 100 g ............ 24

4.1 Konversi Dosis antar Spesies .................................................... 34

5.1 Hasil Uji Kruskal-Wallis .......................................................... 49

5.2 Hasil Uji Mann-Whitney Untuk Nilai Skoring Perdarahan ..... 49

5.3 Hasil Uji Mann-Whitney Untuk Nilai Skoring Infiltrasi Sel

Radang ..................................................................................... 50

5.4 Hasil Uji Mann Whitney Untuk Nilai Skoring Nekrosis ......... 50

DAFTAR GAMBAR

Gambar Halaman

2.1 Aliran Darah Ginjal .................................................................. 12

2.2 Pengamatan Mkroskopis Ginjal Normal ................................... 15

2.3 Anatomi Ginjal Tikus ............................................................... 16

2.4 Histologi korteks ginjal tikus dengan perbesaran 40x .............. 17

2.5 Histopatologi Ginjal Tikus Hiperkolesterolemia ...................... 18

2.6 Penampang Histopatologi Ginjal Tikus .................................... 18

2.7 Perbandingan Histologi Ginjal Tikus dan Manusia .................. 20

2.8 Turi Merah (Sesbania grandiflora (L.) Pers)............................ 21

2.9 Kerangka C6-C3-C6 Flavonoid ................................................ 25

5.1 Gambaran Mikroskopis Ginjal Tikus Tiap Perlakuan .............. 45

5.2 Perbandingan Nilai Skoring Perdarahan Antar Kelompok ...... 46

5.3 Perbandingan Nilai Skoring Infiltrasi Sel Radang Antar

Kelompok ................................................................................. 47

5.4 Perbandingan Nilai Skoring Nekrosis Antar Kelompok .......... 48

DAFTAR SINGKATAN

ACTH : Adenocorticotropic Hormone

Apo B : Apolipoprotein B

CMC : Carboxymethyl Cellulose

CRH : Corticotropin Releasing Hormone

DPPH : 2,2 Diphenil-1 Picryhydrazil

HDL : High-density lipoprotein

HMG : Hidroksi Metil Glutaril

KoA : Koenzim-A

ICAM-1 : Inter Cellular Adhesion Molecule-1

IDL : Intermediate-density lipoprotein

IL-6 : Interleukin-6

LD50

: Lethal Dose 50

LDL : Low-density lipoprotein

MICRO-HOPE : Microalbuminuria, Cardiovascular, and Renal Outcomes in

HOPE Study

NO : Nitrit Oxide

PUFA : Polyunsaturated Fatty Acids

ROS : Reactive Oxygen Species

TF : Total Flavonoid

TGF- β : Transforming Growth Factor-β

TNF-α : Tumor Necrosis Factor-α

TP : Total Phenolic

VCAM-1 : Vascular Cell Adhesion Molecule-1

VLDL : Very Low Density Lipoprotein

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