KARYA TULIS AKHIR PENGARUH PEMBERIAN MINUMAN BERENERGI TERHADAP PENINGKATAN KERUSAKAN HISTOLOGI HEPAR PADA TIKUS PUTIH (rattus novergicus strain wistar)
OLEH: UMI KULSUM 09020051
UNIVERSITAS MUHAMMADIYAH MALANG FAKULTAS KEDOKTERAN 2012
PENGARUH PEMBERIAN MINUMAN BERENERGI TERHADAP PENINGKATAN KERUSAKAN HISTOLOGI HEPAR TIKUS PUTIH STRAIN WISTAR
KARYA TULIS AKHIR Diajukan kepada Universitas Muhammadiyah Malang untuk Memenuhi Salah Satu Persyaratan dalam Menyelesaikan Program Sarjana Fakultas Kedokteran
Oleh : UMI KULSUM 09020051
FAKULTAS KEDOKTERAN UNIVERSITAS MUHAMMADIYAH MALANG 2012
LEMBAR PENGESAHAN LAPORAN HASIL PENELITIAN
Telah disetujui sebagai hasil penelitian untuk memenuhi persyaratan Pendidikan Sarjana Program Pendidikan Dokter Universitas Muhammadiyah Malang Tanggal : 10 Desember 2012
Pembimbing I
dr.Hawin Nurdiana, M.Kes. Pembimbing II
dr. Gita Sekar Prihanti, M.Pd.Ked.
Mengetahui, Fakultas Kedokteran Dekan,
dr. Irma Suswati, M.Kes NIP : 11395010320
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LEMBAR PENGUJIAN
Karya Tulis Akhir oleh Umi Kulsum Telah diuji dan dipertahankan di depan Tim Penguji Pada tanggal 10 Desember 2012
Tim Penguji
dr.Hawin Nurdiana,M.Kes
Ketua
dr. Gita Sekar Prihanti, M.Pd.Ked
Anggota
Prof.Dr.dr.Djoni Djunaedi, Sp.PD,KPTI
Anggota
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KATA PENGANTAR
Assalamualaikum Wr.Wb Syukur alhamdulillah kehadirat Allah SWT yang telah melimpahkan rahmat dan hidayah-Nya, sehingga penulis dapat menyelesaikan Karya Tulis Akhir dengan judul “Pengaruh Pemberian Minuman Berenergi Terhadap Peningkatan Kerusakan Histologi HeparTikus Putih Strain Wistar”. Dalam terwujudnya Karya Tulis Akhir ini penulis ingin mengucapkan terima kasih terutama kepada: 1. Allah SWT atas segala rahmat dan karunia-Mu sehingga hamba mampu menyelesaikan tugas akhir ini dengan baik dan sholawat serta salam senantiasa tercurahkan kepada Rasulullah SAW yang membawa kebenaran. 2. Kedua orang tua dan kakak penulis yang selalu memberikan kasih sayang, doa yang tak henti, dukungan dan selalu mengingatkan penulis. Insya Allah penulis akan selalu berusaha membuat kalian bangga. 3. dr.Irma Suswati, M.Kes selaku Dekan Fakultas Kedokteran Universitas Muhammadiyah Malang. 4. dr. Hawin Nurdiana, M.Kes selaku dosen pembimbing I dalam penulisan Karya Tulis Akhir ini. 5. dr. Gita Sekar Prihanti, M.Pd.Ked selaku dosen pembimbing II dalam penulisan Karya Tulis Akhir ini. 6. Prof.Dr.dr.Djoni Djunaedi, Sp.PD, KPTI selaku dosen penguji dalam penulisan Karya Tulis Akhir ini.
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7. dr. Soebarkah Basuki, Sp.PA selaku pembaca hasil penelitian yang telah memberikan ilmu dan bimbingan dalam pengamatan hasil penelitian 8. Untuk Rani (Lontong), Riris (Nyai), Devi (Eyang), Mutiara, Cut, Amel alva, Mbak Ocha , Isna ayu, Ahmad Rijal Firmansyah,S.Ked, Utari Prasetyaningrum, S.Ked, Annisa Wahyuniarti, S.Ked, Rahayu Endah, S.Ked, M.Remo Lingga, S.Ked Ebi dan teman – teman 2009 di Fakultas Kedokteran Universitas Muhammadiyah Malang. 9. Seluruh Dosen yang telah memberikan ilmunya dan Staf Pengajar dan TU Fakultas Kedokteran Universitas Muhammadiyah Malang. Penulis menyadari bahwa penelitian ini masih jauh dari sempurna, sehingga penulis membuka diri untuk segala kritik dan saran yang bersifat membangun. Akhirnya penulis berharap semoga Karya Tulis Akhir ini dapat bermanfaat bagi masyarakat, khususnya dalam bidang kesehatan. Wassalamualaikum Wr.Wb Malang, 10 Desember 2012
Penulis
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ABSTRAK Kulsum, Umi. 2012. Pengaruh Pemberian Minuman Berenergi Terhadap Peningkatan Kerusakan Histologi Hepar Tikus Putih Strain Wistar. Tugas Akhir, Fakultas Kedokteran, Universitas Muhammadiyah Malang. Pembimbing: (1) Hawin Nurdiana (2) Gita Sekar Prihanti Pendahuluan : Konsumsi minuman berenergi semakin meningkat sejak diperkenalkan di seluruh dunia pada tahun 2006 sebagai minuman yang dapat menambah energi dengan instan. Kandungan utamanya adalah kafein yang merupakan antagonis reseptor adenosin A2a yang dapat meningkatkan aktivasi polymorphonuclear cell dan resiko inflamasi yang menyebabkan kerusakan hepatosit pada sel hepar. Dan carnitine yang membentuk energi tidak spontan sehingga menghambat enzim c 6 phosphate. Tujuan : Membuktikan adanya pengaruh pemberian minuman berenergi terhadap peningkatan kerusakan histologi hepar tikus putih strain wistar. Metode : Eksperimen laboratoris dengan rancangan the post test only control group design. Sampel dibagi dalam 4 kelompok. Kelompok I (K) tanpa pemberian minuman berenergi, kelompok II. III dan IV (P1, P2, P3) diberikan minuman berenergi 72 mg, 216 mg dan 360 mg. Analisis data menggunakan One Way Anova, Test Tukey. Hasil : Hasil uji One Way Anova dan uji Tukey didapatkan nilai sig=0,000 (p<0,01) artinya terdapat pengaruh yang signifikan antara perlakuan dengan jumlah sel nekrosis dan terdapat perbedaan yang bermakna antar kelompok. Kesimpulan : Minuman berenergi dapat meningkatkan jumlah sel nekrosis pada sel hepar.
Kata kunci : Minuman berenergi, kafein dan carnitine , nekrosis sel hepar.
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ABSTRACT Kulsum, Umi. 2012. The Effect of Orally Energy Drinks to The Liver Increased Histological Damage in White Rat Strain Wistar. Final Assignment, Medical Faculty, University of Muhammadiyah Malang, Adviser: (1) Hawin Nurdiana (2) Gita Sekar Prihanti Introduction : The consumption of energic drink has been increasing continuously since it was introduced to worldwide, in 2006 as a supplement which instantly can increase the energy or stamina. The main content of the energic drink is caffeine, (Antagonist Receptor Adenosine A2a) that increas’s the activity of Polymorphonuclears cell and the inflammatory risk that can cause a damage to Hepatic cells. Energic drink also contains Carnitine which create non-spontaneous energy that inhibits c6 phosphate enzyme. Objective : To prove the effect of oral energy drinks to the liver damages in white rat strain wistar. Method : Laboratory experiment by using the post test only control group design. The samples were divided into 4 groups. Group I (K) without energy drink, group II, III and IV (P1, P2, P3) with 72 mg, 216 mg and 360 mg of energic drink. Datas were analyzed by using the One Way Anova, Tukey test. Result : One Way Anova test and Tukey test result’s obtained value sig=0,000 (p<0,01),it means there is a significant effect between treatments with a number of cell necrosis and there are significant differences between groups. Conclusion : Energic drinks can increase the number of cell necrosis in liver. Keywords : Energic drinks, caffeine and carnitine, cell necrosis in liver.
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DAFTAR ISI
DAFTAR ISI.................................................................................................... i DAFTAR TABEL ............................................................................................ vii DAFTAR GAMBAR ....................................................................................... viii DAFTAR SINGKATAN...................................................................................ix BAB 1 PENDAHULUAN .............................................................................. 1 1.1 Latar Belakang ................................................................................ 1 1.2. Rumusan Masalah ........................................................................... 2 1.3. Tujuan .............................................................................................. 3 1.3.1. Tujuan umum ......................................................................... 3 1.3.2. Tujuan khusus ........................................................................ 3 1.4. Manfaat Penelitian ........................................................................... 3 1.4.1 Manfaat akademis ................................................................... 3 1.4.2 Manfaat klinis ......................................................................... 3 1.4.3 Manfaat masyarakat ............................................................... 3 BAB 2 TINJAUAN PUSTAKA....................................................................... 4 2.1 Minuman Berenergi ......................................................................... 4 2.1.1 Definisi minuman berenergi................................................... 4 2.1.2 Target sasaran minuman berenergi ........................................ 5 2.1.3 Kandungan minuman berenergi ............................................. 5 2.1.3.1 Kafein ......................................................................... 5 2.1.3.2 Taurin ......................................................................... 10 2.1.3.3 Guarana ...................................................................... 12 2.1.3.4 Ginseng........................................................................12
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2.1.3.5 Vitamin B kompleks .................................................. 13 2.1.4 Efek minuman berenergi pada tubuh ...................................... 15 2.2 Hepar ............................................................................................... 17 2.2.1Anatomi hepar ......................................................................... 17 2.2.2 Fisiologi hepar ........................................................................ 19 2.2.3 Histologi hepar ....................................................................... 20 2.3 Pengaruh minuman berenergi terhadap kerusakan hepar ................. 27 BAB 3 KERANGKA KONSEP DAN HIPOTESIS ........................................ 32 3.1 Kerangka Konsep ........................................................................... 32 3.2. Hipotesis ........................................................................................ 35 BAB 4 METODE PENELITIAN .................................................................... 36 4.1 Rancangan Penelitian ...................................................................... 36 4.2 Tempat dan Waktu Penelitian .......................................................... 36 4.3 Populasi dan Sampel ....................................................................... 36 4.3.1 Populasi .................................................................................. 36 4.3.2 Sampel .................................................................................... 36 4.3.3 Besar sampel ........................................................................... 36 4.3.4 Karakteristik sampel penelitian .............................................. 38 4.4 Variabel Penelitian ........................................................................... 38 4.4.1 Variabel bebas ......................................................................... 38 4.4.2 Variabel tergantung ................................................................. 38 4.4.3 Variabel kontrol ...................................................................... 38 4.4.4 Definisi operasional ................................................................ 38 4.5 Alat dan Bahan ................................................................................. 40
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4.5.1 Alat ......................................................................................... 40 4.5.2 Bahan ...................................................................................... 40 4.6 Alur penelitian .................................................................................. 42 4.7 Prosedur Penelitian ........................................................................... 43 4.7.1 Adaptasi hewan percobaan ..................................................... 43 4.7.2 Penentuan dosis ...................................................................... 43 4.7.3 Penyiapan larutan uji .............................................................. 43 4.7.4 Percobaan ............................................................................... 44 4.8 Analisis data...................................................................................... 46 BAB 5 HASIL DAN ANALISIS PENELITIAN...........................................47 5.1 Hasil dan Analisis Data Penelitian.....................................................47 5.1.1 Hasil Pengamatan Preparat Histologi Sel Hepar Tikus Putih strain wistar.................................................................................................47 5.1.2 Penelitian Jumlah Sel Nekrosis Pada Sel Hepar Tikus Putih strain wistar.......................................................................................47 5.2 Analisis Data......................................................................................51 BAB 6 PEMBAHASAN..................................................................................52 BAB 7 KESIMPULAN DAN SARAN...........................................................56 7.1 Kesimpulan........................................................................................56 7.2 Saran..................................................................................................56 DAFTAR PUSTAKA ....................................................................................... 57 LAMPIRAN.....................................................................................................63
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DAFTAR GAMBAR
Gambar 2.1 Struktur Kimia Kafein .................................................................. 6 Gambar 2.2 Struktur Umum Anatomi Hepar ................................................... 19 Gambar 2.3 Struktur Umum Histologi Hepar .................................................. 21 Gambar 2.4 Histologi Hepar Yang Mengalami Perlemakan ........................... 25 Gambar 2.5 Histologi Hepar Yang Mengalami Nekrosis ................................ 27 Gambar 5.1 Panah berwarna kuning menunjukkan nekrosis............................48 Gambar 5.3 Grafik Hasil Penelitian Jumlah Sel Nekrosis Hepar.....................50
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DAFTAR SINGKATAN ADH
: Anti Diuretic Hormone
ADP
: Adenosine Diphosphate
AMP
: Adenosine Monophosphate
ATP
: Adenosine Triphosphate
cAMP
: cyclic Adenosine Monophosphate
DNA
: Deoxyribose Nucleic Acid
LD
: Lethal Dose
NAD
: Nicotinamide Adenine Dinucleotide
NADH
: Nicotinamide Adenine Dinucleotide Hydrogen
NADP
: Nicotinamide Adenine Dinucleotide Phosphate
NADPH
: Nicotinamide Adenine Dinucleotide Phosphate Hydrogen
PKC
: Protein Kinase C
PMN
: Polymorphonuclear Cells
RNA
: Ribo Nucleic Acid
ROS
: Reactive Oxygen Species
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