糖尿病足感染发病机制及抗感染治疗研究进展  

Research progress on the pathogenesis of diabetic foot infection and anti-infection treatment

作　　者：蔡钦云 孔亮 严雪冰 CAI Qinyun;KONG Liang;YAN Xuebing(School of Medicine,Yangzhou University,Yangzhou 225009,Jiangsu,China;Af filiated Hospital of Yangzhou University)

机构地区：[1]扬州大学医学院,江苏扬州225009 [2]扬州大学附属医院

出　　处：《中国病原生物学杂志》2025年第3期405-407,F0003,共4页Journal of Pathogen Biology

摘　　要：糖尿病足是糖尿病患者常见的严重并发症之一,复发率和截肢率高,带来身体痛苦和经济负担。它的临床表现多样复杂,从皮肤病变到组织坏死和系统性感染,愈合慢且易复发,神经病变使早期识别困难。糖尿病足感染发病机制包括高血糖对免疫系统的影响,削弱白细胞功能、影响细胞因子等,还促进AGEs形成致慢性炎症;以及局部微环境变化,如微循环障碍和神经病变致组织缺氧和营养不良,为病原体提供条件。本文介绍了临床诊断标准及实验室和影像学评估,临床标准包括观察足部及评估溃疡等,实验室检查有微生物培养等,影像学评估能揭示结构变化。引起糖尿病足感染病原菌具有多样性,以金黄色葡萄球菌、大肠埃希菌和铜绿假单胞菌等常见。糖尿病足感染发病的危险因素有足部解剖结构、代谢紊乱、血管和神经病变、生活习惯与环境及药物治疗等多个因素。血糖控制和日常护理对预防糖尿病足感染有着重要意义,如控制HbA1c水平可降感染风险。治疗原则有血糖控制、伤口护理及必要时手术等。Diabetic foot is one of the common and serious complications in diabetic patients,with high recurrence and amputation rates,bringing physical pain and economic burden.Its clinical manifestations are diverse and complex,ranging from skin lesions to tissue necrosis and systemic infections,with slow healing and easy recurrence,and neuropathy makes early identification difficult.The pathogenesis of diabetic foot infection includes the impact of hyperglycemia on the immune system,weakening the function of white blood cells,affecting cytokines,etc.,and also promoting the formation of AGEs,leading to chronic inflammation;as well as changes in the local microenvironment,such as microcirculation disorders and neuropathy,resulting in tissue hypoxia and malnutrition,providing conditions for pathogens.This article introduces the clinical diagnostic criteria and laboratory and imaging evaluations.The clinical criteria include observing the foot and assessing ulcers,etc.Laboratory examinations include microbial culture,etc.,and imaging evaluations can reveal structural changes.The pathogens causing diabetic foot infections are diverse,with Staphylococcus aureus,Escherichia coli,Pseudomonas aeruginosa,etc.being common.The risk factors for the development of diabetic foot infections include multiple factors such as foot anatomical structure,metabolic disorders,vascular and nerve lesions,lifestyle and environmental factors,and drug treatment.Blood glucose control and daily care are of great significance for preventing diabetic foot infections.For example,controlling the HbAlc level can reduce the risk of infection.The treatment principles include blood glucose control,wound care,and surgery when necessary.

关 键 词：糖尿病足 发病机制 病原菌分布 预防治疗 综述 

分 类 号：R47[医药卫生—护理学]