糖尿病皮肤病变及其机制的研究进展

Recent progress of ＂underlying disorder＂ of diabetic skin

糖尿病皮肤在未遭遇外源性损伤的情况下即已存在组织学和细胞功能学的异常改变。由于糖尿病皮肤存在含糖量增高以及晚期糖基化终末产物蓄积、基质金属蛋白酶及其抑制剂的比例失平衡、生长因子异常、炎性反应等异常改变，导致糖尿病皮肤厚度变薄，皮肤层次减少，结缔组织变性，细胞形态变异，黏附力及增殖能力下降，胶原合成紊乱。这种有别于皮肤组织完整性破坏的隐匿性损害可能是糖尿病皮肤易损或创面形成后难以愈合的重要原因之一.

Some cutaneous histological and pathophyslological alterations in the diabetic skin exist before injury. A set of local biochemical factors such as high concentration of glucose and advanced glycation end products,imbalance of MMPs/TIMPs, abnormal growth factor and disorder of inflammatory reaction,lead to the reduction of skin thickness and layer, denaturation of connective tissue, variation of cell morphology, decline of cell adhesion and proliferation and abnormal collagen formation. This kind of＂ underlying disorder＂, which is different from the impaired wound, may give rise to ulceration in diabetic skin and be one of the most important mechanisms in the pathogenesis of impaired wound healing.