International Journal of Clinical Research
International Journal of Clinical Research. 2026; 10: (2) ; 10.12208/j.ijcr.20260066 .
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1 大理大学临床医学院 云南大理
2 云南省第三人民医院 云南昆明
*通讯作者： 桂莉,单位：；
糖尿病足溃疡（diabetic foot ulcers，DFUs）因高糖微环境、血管病变及免疫功能紊乱等多种因素导致愈合缓慢、易感染，临床治疗难度较高。通过从新鲜血液中提取高浓度血小板血浆，称为富血小板血浆（platelet-rich plasma，PRP），其活化后形成血小板凝胶（platelet-rich gel，PRG），因富含血小板衍生生长因子、血管内皮生长因子等多种生物活性物质，可通过促进成纤维细胞增殖、加速血管新生、调控局部炎症反应，为糖尿病伤口愈合创造良好微环境，近年来成为该领域的研究热点。本文从制备方法、临床疗效、体外抑菌及展望四个维度展开综述。综合分析显示，临床研究表明APG作为DFU的辅助治疗手段，可显著提高愈合率（部分研究显示提高39%～53%）并缩短愈合时间，尤其适用于慢性非缺血性伤口。然而，其疗效可能受制备方法、白细胞含量、血小板浓度及伤口严重程度影响。体外研究证实PRG对常见致病菌如金黄色葡萄球菌、大肠杆菌有短暂抑制作用，但对多重耐药菌效果有限。未来需开展高质量、标准化的多中心随机对照试验以明确最佳治疗方案，并探讨其与抗感染、血管重建等疗法的联合应用价值。
Diabetic foot ulcers (DFUs) are featured by delayed healing and high susceptibility to infection as a result of multiple factors including hyperglycemic microenvironment, vascular lesions, and immune dysfunction, which render them highly challenging to manage in clinical practice. Platelet-rich plasma (PRP) refers to a plasma fraction with concentrated platelets isolated from fresh whole blood. Upon activation, PRP forms platelet-rich gel (PRG), which is abundant in various bioactive molecules such as platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF). By promoting fibroblast proliferation, accelerating angiogenesis, and modulating local inflammatory responses, PRG establishes a favorable microenvironment for diabetic wound repair, thus emerging as a research hotspot in this field in recent years. This review elaborates on the current advances from four aspects: preparation methods, clinical efficacy, in vitro antibacterial activity, and future perspectives. Comprehensive analysis demonstrates that clinical studies have verified PRG as an effective adjuvant therapy for DFUs, which can markedly elevate the wound healing rate (with some studies reporting an improvement ranging from 39% to 53%) and shorten the healing duration, especially for chronic non-ischemic wounds. However, its therapeutic effects may be affected by several factors, such as preparation protocols, leukocyte content, platelet concentration, and wound severity. In vitro studies have confirmed that PRG exerts a transient inhibitory effect on common pathogenic bacteria including Staphylococcus aureus and Escherichia coli, yet its efficacy against multidrug-resistant bacteria remains limited. In the future, it is imperative to conduct high-quality, standardized multicenter randomized controlled trials to identify the optimal therapeutic regimen, and further explore the value of its combined application with other strategies such as anti-infective therapy and vascular reconstruction.
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