糖尿病皮肤组织“隐性损害”机制研究进展

Advances in research of the mechanism of ＂ covert disorder＂ in diabetic skin

糖尿病皮肤损伤由自发性或外源性创面引起，其中糖尿病足的皮肤损伤发生率较高，其难愈性以及带来的截趾（肢）风险，至今仍是临床面临的重大难题，需从糖尿病创面的发病机制来探寻较为有效的治疗方法。在病程较长的糖尿病皮肤创面中存在高糖和晚期糖基化终末产物（AGE）的蓄积，

The diabetic ulceration is not uncommon,and becomes refractory,as the skin in a diabetic patient is relatively thin as well as hypoesthetic and less sensitive to temperature.As there are already preexisting histological and cellular derangement in the skin,healing of the skin injury is difficult,thus resulting in an intractable ulceration.When diabetes is not controlled,the skin contents of sugar and advanced glycation end product accumulate,invoking cellular deformation and accumulation of matrix metalloproteinases（MMP）,resulting in an imbalance between MMP and its inhibitors, malfunction of growth factors,and inflammatory reaction.These processes lead to obvious skin thinning,denaturation of connective tissues,thickening of vascular basal membrane,and neuropathy,etc.These pathological alterations could be recognized as ＂ covert disorder＂ of skin in diabetic patients and may be underlying disorders in producing indolent diabetic ulcers.