目的 探讨缬沙坦分散片联合前列地尔注射液治疗糖尿病肾病的疗效。方法 选取延安市人民医院肾脏内科2012年3月-2015年12月收治的糖尿病肾病230例，随机分为两组。缬沙坦组（109例）口服缬沙坦分散片治疗，联合用药组（121例）口服缬沙坦分散片加静脉滴注前列地尔注射液治疗，观察并记录治疗前后尿素氮（BUN）、血肌酐（Cr）、尿白蛋白排泄率（UAER）、血浆黏度、红细胞比容、血沉方程K值、血浆纤维蛋白原等指标的变化，评价前列地尔注射液联合缬沙坦分散片治疗糖尿病肾病的疗效。结果 与治疗前相比，治疗后两组BUN、Cr、UAER等各项指标均明显下降（P<0.05），且联合用药组这些指标明显低于缬沙坦组（P<0.05）。与治疗前相比，治疗后两组血浆黏度、红细胞比容、血沉方程K值、血浆纤维蛋白原水平均明显下降（P<0.05），且联合用药组在上述指标的水平均明显低于缬沙坦组（P<0.05）。随访1个月期间，缬沙坦组不良反应6例，联合用药组3例，两组均无严重不良反应。结论 前列地尔注射液联合缬沙坦分散片对糖尿病肾病具有较好的治疗效果，能减少尿蛋白排出，改善肾功能和肾脏血液流变学指标，不良反应轻微，值得临床推广使用。

Objective To analyze the efficacy of Valsartan Tablets combined with Alprostadil Injection in the treatment of diabetic nephropathy. Methods Totally 230 cases of diabetic nephropathy were selected in Yan'an People's Hospital from March 2012 to December 2015, randomly divided into two groups. The Valsartan group (109 cases) were given Valsartan Tablets. The combination group (121 cases) were given Valsartan Tablets and Alprostadil Injection. The efficacy of the Valsartan Tablets and Alprostadil Injection in the treatment of diabetic nephropathy was evaluated by BUN, Cr, UAER, plasma viscosity, hematocrit, ESR equation K value, and plasma fibrinogen. Results Compared with the values before treatment, the indexes of BUN, Cr, and UAER in two groups were significantly decreased (P<0.05), and the combination group of renal function, and urinary protein index was significantly lower than the Valsartan group (P<0.05). Compared with the values before treatment, the indexes of plasma viscosity, hematocrit, ESR equation K value, and plasma fibrinogen in two groups were significantly decreased (P<0.05). During the 1 month follow-up, there were six cases of adverse reactions in Valsartan group, three cases in the combined treatment group, and no serious adverse reaction in the two groups. Conclusion The Valsartan Tablets combined with Alprostadil Injection had good effect on diabetic nephropathy. This treatment could decrease the urine protein, improve the renal function and hemorheology indexes of kidney and have mild side reaction. It was worthy of clinical application.