Tsukatani Toshihiro, Minematsu Takeo, Dai Misako, Tamai Nao, Nakagami Gojiro, Sugama Junko, Takada Chika, Sanada Hiromi
Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Wound Repair Regen. 2021 Sep;29(5):741-751. doi: 10.1111/wrr.12912. Epub 2021 Apr 5.
Advances in patient care for pressure injuries (PIs) have reduced the prevalence of PIs in Japan, although not in recent years. Several single-nucleotide polymorphisms (SNPs) have been identified in genes potentially associated with PIs. However, individual variance among PI risks require targeted investigations that may lead to the identification of PI susceptibilities or preventive care options that directly influence PI development pathways. This cross-sectional study examined the association between PIs and SNPs in genes related to tissue tolerance in patients in a long-term care hospital in Japan. A total of 178 participants (130 control, 20 with superficial PI history, and 28 with deep PI history) were enrolled in this study of eight SNPs in hypoxia inducible factor 1 subunit alpha (HIF1A), vascular endothelial growth factor C (VEGFC), heat shock protein 90 alpha family class A member 1 (HSP90AA1), myostatin (MSTN), and vitamin D receptor (VDR). The primary outcome was a history of superficial and deep PIs in the last 6 months. SNPs were examined by real-time polymerase chain reaction, followed by multivariate logistic regression analyses of the associations between the SNPs and PI history. The results showed a significant association between VEGFC rs1485766 and the history of superficial PIs (odds ratio = 2.95; 95% confidence interval = 1.07-8.11; p = 0.04). Stratified analysis using the Braden Scale (≤14) indicated a significant association between HIF1A rs11549465 and deep PIs (p = 0.04). Our study demonstrated that VEGFC rs1485766 and HIF1A rs11549465 were associated with superficial and deep PI susceptibilities, respectively.
尽管近年来日本压疮（PI）患者护理方面的进展未能降低PI的患病率，但仍取得了一定成效。在可能与PI相关的基因中已鉴定出几种单核苷酸多态性（SNP）。然而，PI风险中的个体差异需要针对性研究，这可能有助于识别PI易感性或直接影响PI发生途径的预防护理方案。这项横断面研究调查了日本一家长期护理医院患者中PI与组织耐受性相关基因中的SNP之间的关联。共有178名参与者（130名对照者、20名有浅表PI病史者和28名有深部PI病史者）纳入了这项针对缺氧诱导因子1α亚基（HIF1A）、血管内皮生长因子C（VEGFC）、热休克蛋白90α家族A类成员1（HSP90AA1）、肌肉生长抑制素（MSTN）和维生素D受体（VDR）的8个SNP的研究。主要结局是过去6个月内浅表和深部PI的病史。通过实时聚合酶链反应检测SNP，随后对SNP与PI病史之间的关联进行多因素逻辑回归分析。结果显示，VEGFC rs1485766与浅表PI病史之间存在显著关联（优势比=2.95；95%置信区间=1.07-8.11；p=0.04）。使用Braden量表（≤14）进行的分层分析表明，HIF1A rs11549465与深部PI之间存在显著关联（p=0.04）。我们的研究表明，VEGFC rs1485766和HIF1A rs11549465分别与浅表和深部PI易感性相关。
