Ge Xiao-jing, Jiang Yu-zhi, Zhang Hong-wei
Department of Burns and Plastic Surgery, Nanjing Medical University, Nanjing, China.
Zhonghua Shao Shang Za Zhi. 2012 Feb;28(1):51-3.
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.
糖尿病溃疡并不少见，且会变得难以治愈，因为糖尿病患者的皮肤相对较薄，感觉减退，对温度不太敏感。由于皮肤中已经存在组织学和细胞紊乱，皮肤损伤难以愈合，从而导致难治性溃疡。当糖尿病得不到控制时，皮肤中的糖和晚期糖基化终产物会积累，引起细胞变形和基质金属蛋白酶（MMP）的积累，导致MMP与其抑制剂之间失衡、生长因子功能失调以及炎症反应。这些过程会导致皮肤明显变薄、结缔组织变性、血管基底膜增厚和神经病变等。这些病理改变可被视为糖尿病患者皮肤的“隐性紊乱”，可能是导致糖尿病慢性溃疡的潜在紊乱。
