王记凯,王献珍

糖尿病患者体内长期处于存在的高糖环境会导致糖尿病慢性创面包括糖尿病足、糖尿病慢性溃疡在内的严重慢性并发症。糖尿病慢性创面由于长期处于高血糖、高水平的氧化应激和炎症的环境以及其易受感染等不利因素导致糖尿病慢性创面愈合缓慢或进一步恶化。糖尿病慢性创面是糖尿病患者死亡的重要原因之一。高糖环境会破坏对再上皮化至关重要的过程，即角质形成细胞和成纤维细胞的蛋白质合成、迁移和增殖，从而阻碍伤口愈合所需的基质-细胞相互作用，最终导致伤口愈合缓慢或者不愈合；外泌体表面存在的CD47可以保护其免受吞噬作用并限制其清除形式循环，因此外泌体本身或作为药物有效载荷递送的载体，作为治疗剂正在被积极探索；红景天是一种具有食用价值和药用价值的多功能植物，目前有大量研究发现，该药材具有抗氧化、抗炎、抗癌、调节代谢和神经保护等功效。其主要活性成分红景天苷在干细胞的增殖、迁移、分化中起到调控作用。本文基于外泌体和红景天材料的特点和糖尿病慢性创面的微环境，总结了近年来红景天外泌体治疗糖尿病慢性创面的研究进展，并探讨了目前红景天外泌体的缺点和展望，让糖尿病伤口的个性化管理和治疗成为可能。

糖尿病；糖尿病慢性创面；外泌体；红景天

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