创面难愈机制研究——糖尿病皮肤的"微环境污染"

在创面修复中,糖尿病合并难愈创面是最值得重视的领域之一.其中糖尿病下肢溃疡特别是糖尿病足的发生率日渐升高,但治疗手段局限,预后较差.迄今认为,糖尿病足的发生基于血管神经病变,表现为伴有血供不足和感染的创面愈合延迟与溃疡形成[1],涉及组织细胞、细胞外基质、生长因子等诸多环节[2],但在此研究基础上衍生出来的治疗策略仍然不尽如人意.

A potential mechanism for impaired wound healing——cutaneous environmental disorders in diabetes mellitus

Impaired wound healing in diabetes is a significant clinical problem which is thought to be associated with neuropathy and angiopathy previously . The present study indicates that accumulation of glucose and glycometabolic products in skin tissue, as the result of glycometabolic disorders, which contributes to cutaneous environmental alterations in diabetes mellitus, and subsequently induces the abnormal cell behaviors, cytokine alteration and matrix modification. Thus, diabetic neuropathy and angiopathy might be regarded as the pathological outcome of cutaneous environmental alterations. In conclusion, glycometabolism disorders could be described as one of the initial events for the alteration involving in the underlying cutaneous disorder which impair healing process. The related research focuses on the initial event of controlling disorders in wound healing and therefore contribute to providing the strategy of treatment as based on these approaches.