目的：探讨脐带间充质干细胞来源外泌体（hUCMSC-Exos）对糖尿病性角膜病变（DK）的保护作用及对焦亡核心因子Caspase-1的调控机制。方法：SPF级SD大鼠随机分为正常对照组、糖尿病模型组（STZ腹腔注射）及hUCMSC-Exos干预组；采用角膜共聚焦显微镜、荧光素钠及虎红染色评估角膜表型。体外以高糖（25 mmol/L）培养人角膜上皮细胞（HCECs）同法验证。结果：hUCMSC-Exos干预可显著降低荧光素钠染色评分（P＜0.05），改善角膜上皮连续性；体内外结果显示高糖状态下角膜Caspase-1 mRNA上调，hUCMSC-Exos干预后恢复正常水平，高度一致。结论：hUCMSC-Exos可改善DK角膜上皮损伤，其保护机制可能与抑制Caspase-1依赖的细胞焦亡通路有关，为DK防治提供了新的实验依据。

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