中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (19): 4897-4901.doi: 10.12307/2026.797

• 脐带脐血干细胞 umbilical cord blood stem cells • 上一篇    下一篇

人脐带间充质干细胞来源外泌体治疗糖尿病足溃疡

李天博1，2，于泽洋1，2，秦新愿1，2，王江宁1，高  磊1，2   

  1. 首都医科大学附属北京世纪坛医院，1矫形外科，2整形外科，北京市  100038
  • 收稿日期:2025-09-23 接受日期:2025-12-03 出版日期:2026-07-08 发布日期:2026-02-14
  • 通讯作者: 高磊，博士，副主任医师，硕士研究生导师，首都医科大学附属北京世纪坛医院整形外科，北京市 100038
  • 作者简介:李天博，男，1990年生，北京市人，汉族，主治医师，主要从事难愈合创面修复、间充质干细胞来源外泌体方向研究。
  • 基金资助:
    北京炎华血管与创面诊疗技术发展基金会资助项目(2022-B01)，项目负责人：王江宁

Exosomes derived from human umbilical cord mesenchymal stem cells in treatment of diabetic foot ulcers

Li Tianbo1, 2, Yu Zeyang1, 2, Qin Xinyuan1, 2, Wang Jiangning1, Gao Lei1, 2   

  1. 1Department of Orthopedic Surgery, 2Department of Plastic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • Received:2025-09-23 Accepted:2025-12-03 Online:2026-07-08 Published:2026-02-14
  • Contact: Gao Lei, MD, Associate chief physician, Master’s supervisor, Department of Orthopedic Surgery, and Department of Plastic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • About author:Li Tianbo, Attending physician, Department of Orthopedic Surgery, and Department of Plastic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • Supported by:
    Beijing Yanhua Vascular and Wound Treatment Technology Development Foundation, No. 2022-B01 (to WJN)

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摘要：

文题释义：

外泌体：是细胞分泌的直径为30-200 nm的膜性小囊泡，能够携带蛋白质、核酸及脂质等多种活性成分，在细胞间传递信号。几乎所有的细胞都可以通过胞吐方式分泌外泌体，该研究所关注的人脐带间充质干细胞来源外泌体，因无细胞结构、免疫原性低，成为近年来 “无细胞治疗”的重要方向。它们能够通过改善创面微环境、促进血管生成和抑制炎症，为糖尿病足溃疡修复提供新的思路。
糖尿病足溃疡：是糖尿病患者最严重的慢性并发症之一，形成机制复杂，包括糖代谢异常、血管病变及神经病变等，导致创面长期难以愈合。寻找新的治疗手段成为临床研究的重点，而干细胞来源外泌体疗法正是这一背景下的探索方向。

摘要
背景：间充质干细胞来源外泌体在调控细胞凋亡、促进细胞再生与改善创面微环境方面有重要作用，成为糖尿病足溃疡治疗研究的热点方向。
目的：探讨人脐带间充质干细胞来源外泌体在糖尿病足溃疡修复中的临床应用价值。
方法：回顾性分析2022年5月至2025年4月治疗的72例糖尿病足溃疡患者资料，其中36足溃疡创面采用人脐带间充质干细胞来源外泌体治疗(观察组)，36足溃疡创面采用封闭式负压引流术治疗(对照组)。比较两组患者治疗2周后的溃疡愈合率、不良事件发生率、血清中炎症标志物、生长因子水平，两组患者创面愈合总时间以及随访期的溃疡复发率。
结果与结论：①治疗2周后，观察组溃疡愈合率(48.03±6.12)%明显高于对照组(30.13±6.38)%，差异有显著性意义(P < 0.05)；②两组患者溃疡均愈合，其中观察组愈合时间为(30.42±2.30) d，较对照组(43.94±3.46) d显著缩短，差异有显著性意义(P < 0.05)；③对照组和观察组治疗期间不良事件发生率分别为13.89%，19.44%，差异无显著性意义(P > 0.05)；④两组患者血清白细胞介素6、C-反应蛋白、降钙素原水平均显著下降，且观察组下降幅度更大，差异有显著性意义(P < 0.01)，两组患者血清血管内皮生长因子、碱性成纤维细胞生长因子、血小板衍生生长因子水平均明显升高，且观察组升高幅度更大，差异有显著性意义(P < 0.01)；⑤观察组溃疡愈合后获平均9.4个月随访，5例患者溃疡复发，对照组溃疡愈合后获平均9.8个月随访，10例患者溃疡复发，观察组复发率显著低于对照组(13.9%，27.8%)，差异有显著性意义(P < 0.05)。结果表明，与封闭式负压引流术相比，应用人脐带间充质干细胞来源外泌体修复糖尿病足溃疡可有效抑制炎症、促进溃疡愈合、降低复发率，且未增加相关不良事件风险，兼具疗效与安全性。

关键词: 糖尿病足溃疡, 人脐带间充质干细胞, 外泌体, 封闭式负压引流, 溃疡愈合率, 白细胞介素6, 血管内皮生长因子, 血小板衍生生长因子

Abstract: BACKGROUND: Exosomes derived from mesenchymal stem cells play an important role in regulating apoptosis, promoting cell regeneration, and improving the wound microenvironment, making them a hot research topic in the treatment of diabetic foot ulcers.
OBJECTIVE: To explore the clinical application value of exosomes derived from human umbilical cord mesenchymal stem cells in the repair of diabetic foot ulcers.
METHODS: A retrospective analysis was conducted on the data from 72 patients with diabetic foot ulcers treated between May 2022 and April 2025. Thirty-six patients received treatment with exosomes derived from human umbilical cord mesenchymal stem cells (observation group), and 36 patients were managed with vacuum-assisted closure therapy (control group). Ulcer healing rate, incidence of adverse events, serum inflammatory markers, growth factor levels, total wound healing time, and ulcer recurrence rate during follow-up were compared between the two groups after 2 weeks of treatment.
RESULTS AND CONCLUSION: (1) After 2 weeks of treatment, the ulcer healing rate in the observation group (48.03±6.12)% was significantly higher than that in the control group (30.13±6.38)%, with a statistically significant difference (P < 0.05). (2) All patients in both groups achieved ulcer healing. The healing time was significantly shorter in the observation group than in the control group (30.42±2.30 versus 43.94±3.46 days), with a statistically significant difference (P < 0.05). (3) The incidence of adverse events during treatment was 13.89% in the control group and 19.44% in the observation group, with no significant difference (P > 0.05). (4) Serum interleukin-6, C-reactive protein, and procalcitonin levels decreased significantly in both groups, with greater reductions in the observation group, with a statistically significant difference (P < 0.01). Serum vascular endothelial growth factor, basic fibroblast growth factor, and platelet-derived growth factor levels increased significantly in both groups, with greater increases in the observation group, with a statistically significant difference (P < 0.01). (5) Following ulcer healing, the mean follow-up durations were 9.4 months in the observation group and 9.8 months in the control group; ulcer recurrence occurred in 5 and 10 patients, respectively, with a significantly lower recurrence rate in the observation group than in the control group (13.9% versus 27.8%), with a statistically significant difference (P < 0.05). These findings indicate that compared with the use of closed negative pressure drainage, the application of exosomes derived from mesenchymal stem cells for treating diabetic foot ulcers effectively suppresses inflammation, promotes ulcers healing, reduces recurrence rates, and does not increase the risk of related adverse events. This approach exhibits both clinical efficacy and safety.

Key words: diabetic foot ulcers, human umbilical cord mesenchymal stem cells, exosomes, vacuum sealing drainage, ulcer healing rate, serum interleukin-6, vascular endothelial growth factor, platelet-derived growth factor

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