Electronic Theses and Dissertation

Latar Belakang: Stroke iskemik merupakan penyebab utama morbiditas dan mortalitas global. Aterosklerosis arteri serebral melibatkan proses inflamasi kronis yang memicu pembentukan plak, menyempitkan lumen arteri, dan mengganggu suplai darah otak. Rasio neutrofil limfosit mencerminkan status inflamasi sistemik, peningkatan neutrofil menandakan respons inflamasi akut, sedangkan penurunan limfosit mengindikasikan penurunan imunitas adaptif. RNL tinggi dilaporkan berkaitan dengan risiko stroke dan luas stenosis.
Tujuan: Menganalisis hubungan antara luas stenosis dengan rasio neutrofil limfosit pada pasien stroke iskemik di RSUD dr. Zainoel Abidin Banda Aceh. Metode: Penelitian observasional analitik dengan desain cross sectional menggunakan total sampling pada pasien stroke iskemik yang dirawat Februari–April 2025. Luas stenosis diukur melalui Digital Subtraction Angiography, sedangkan RNL diperoleh dari pemeriksaan laboratorium.
Hasil: Sebanyak 44 pasien memenuhi kriteria, mayoritas laki-laki, rata-rata usia 56 tahun. Sebagian besar pasien dengan hipertensi disertai diabetes mellitus (45%), hipertensi disertai diabetes mellitus dan dislipidemua (27%), hipertensi saja (18%). Hipertensi disertai dengan diabetes mellitus, dislipidemia, dan penyakit jantung (4,5%) dan hipertensi disertai dislipidemia (4,5%). Rata-rata rasio neutrofil limfosit adalah 4,90 ± 2,71. Terdapat hubungan signifikan antara RNL dan luas stenosis dengan korelasi kuat secara statistik (p=0.000, r=0.671).
Diskusi: Rasio neutrofil limfosit berhubungan erat dengan stenosis arteri intraserebral. Neutrofil berperan sebagai indikator peradangan dan berkontribusi pada aterosklerosis melalui pelepasan sitokin proinflamasi dan oksiradikal yang memicu disfungsi endotel. Temuan ini memperkuat potensi rasio neutrofil limfosit sebagai penanda non-invasif progresivitas stenosis pada stroke iskemik.

Kata kunci: Stroke iskemik, luas stenosis intrakranial, Rasio neutrofil limfosit

Background: Ischemic stroke is a leading cause of global morbidity and mortality. Cerebral arterial atherosclerosis involves chronic inflammatory processes that promote plaque formation, narrow the arterial lumen, and impair cerebral blood flow. Neutrophil-to-lymphocyte ratio (NLR) reflects systemic inflammatory status; increased neutrophils indicate acute inflammatory response, while decreased lymphocytes suggest impaired adaptive immunity. Elevated NLR has been reported to correlate with stroke risk and the stenosis severity. Objective: To analyze the relationship between the degree of stenosis and NLR in ischemic stroke patients at Dr. Zainoel Abidin General Hospital, Banda Aceh. Methods: This was an analytical observational study with a cross-sectional design, using total sampling of ischemic stroke patients admitted between February and April 2025. Degree of stenosis was measured using Digital Subtraction Angiography, while NLR values were obtained from laboratory tests. Results: A total of 44 patients met the inclusion criteria, the majority of whom were male, with a mean age of 56 years. Most patients had hypertension with diabetes mellitus (45%), hypertension with diabetes mellitus and dyslipidemia (27%), hypertension alone (18%), hypertension with diabetes mellitus, dyslipidemia, and heart disease (4.5%), and hypertension with dyslipidemia (4.5%). NLR mean was 4.90 ± 2.71. A significant association was found between NLR and the degree of stenosis, with a strong statistical correlation (p=0.000, r=0.671). Discussion: The NLR is closely associated with intracerebral arterial stenosis. Neutrophils serve as markers of inflammation and contribute to atherosclerosis by releasing proinflammatory cytokines and oxygen-free radicals that induce endothelial dysfunction. These findings support the potential role of NLR as a non-invasive marker of stenosis progression in ischemic stroke. Keywords: ischemic stroke, intracranial stenosis degree, neutrophil-to-lymphocyte ratio