糖尿病溃疡及其与内质网应激的关系研究进展

Research Progress of Diabetic Ulcer and Its Relationship with Endoplasmic Reticulum Stress

摘要: 糖尿病足溃疡(DFU)是成人糖尿病患者最严重的并发症之一。足部溃疡的后果包括功能状态下降、感染、住院、下肢截肢和死亡。足部溃疡的终生风险为19%至34%，随着糖尿病患者的寿命延长和医疗复杂性的增加，这一数字正在上升。溃疡发作后的发病率很高，3~5年复发率为5%，终生下肢截肢发生率为20%，5年死亡率为50%~70%。新数据显示，在经历了长期下降之后，过去几年中一些地区的总体截肢发生率增加了50%，特别是在年轻人和少数民族人口中。DFU是糖尿病的一种常见且高度病态的并发症。溃疡的通路，包括感觉丧失、缺血和轻微创伤。本综述描述了DFU的病因，总结了常规治疗策略，筛查和预防建议，并讨论了目前内质网应激与DFU可能存在的联系及未来治疗策略。

Abstract: Diabetic foot ulcer (DFU) is one of the most serious complications in adults with diabetes. The con-sequences of foot ulcers include reduced functional status, infection, hospitalization, lower limb amputation, and death. The lifetime risk of foot ulcers ranges from 19% to 34%, and this number is rising as people with diabetes live longer and medical complexity increases. Morbidity after an ul-cer attack is high, with a recurrence rate of 5% at 3 to 5 years, a lifetime lower limb amputation rate of 20%, and a 5-year mortality rate of 50% to 70%. New data show that, after a long decline, overall amputation rates have increased by 50% in some areas over the past few years, particularly among young and ethnic minority populations. DFU is a common and highly morbid complication of diabe-tes mellitus. The pathways of ulceration, including sensory loss, ischemia, and minor trauma, have been identified. This review describes the etiology of DFU, summarizes conventional treatment strategies, screening and prevention recommendations, and discusses the current possible link between ER stress and DFU and future treatment strategies.