目的 探讨左卡尼汀联合前列地尔治疗糖尿病肾病的临床疗效及其安全性。方法 选择2013年8月-2016年12月在内蒙古医科大学附属医院就诊的糖尿病肾病患者102例，随机分为两组，对照组50例，患者接受前列地尔注射液治疗；联合组52例，在对照组的基础上，联合应用左卡尼汀，两组均持续治疗1个月。分别检测两组患者治疗前后的血糖水平以及肾功能相关指标；评价两组患者治疗后的临床疗效，记录并分析两组患者在治疗期间不良反应的发生情况。结果 经治疗，两组患者的空腹血糖（FBG）、餐后2 h血糖（2 h BG）、24 h蛋白尿（24 h uPro）、血尿素氮（BUN）、血肌酐（Scr）以及尿微球蛋白（β2-MG）等均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且联合组以上指标均低于对照组，差异有统计学意义（P<0.05）。经治疗，联合组患者的治疗总有效率为94.2%，显著高于对照组的70.0%，差异有统计学意义（P<0.05）。治疗期间，对照组发生不良反应的总发生率为20.0%（10/50），联合组为5.8%（3/52），其差异无统计学意义。结论 左卡尼汀联合前列地尔用于治疗糖尿病肾病临床疗效显著，可有效控制血糖，改善肾功能，一定程度降低不良事件的发生率，值得临床推广应用。

Objective To explore the curative effect and safety of L-carnitine combined with alprostadil for patients with diabetic nephropathy. Methods 102 patients with diabetic nephropathy were enrolled in hospital of Inner Mongolia normal university from August 2013 to December 2016, of which patients divided into two groups randomly, control group (n=50) accepted alprostadil treatment, and combined group (n=52) adopted L-carnitine based on the patients in control group. The blood glucose and renal functions were detected respectively after treatment. And the curative effect was evaluated and compared between two groups; The adverse reactions were recorded and analyzed in the period of treatment. Results After treatment, the FBP, 2 h BG, 24 h uPro, BUN, Scr and β2-MG of patients in two groups were decreased significantly (P<0.05), and the change of combined group was higher than those control group significantly (P<0.05). After treatment, the total efficiency of combined group was higher than that patients in control group (P<0.05). The incidence of adverse reactions of control group in the period of treatment was 20.0% (10/50), and combined group was 5.8% (3/52), and which difference from two groups was no significance. Conclusions L-carnitine combined with alprostadil for patients with diabetic nephropathy deserved popularization in clinic, and which not only possessed remarkable curative effect, but also well controlled the blood glucose level, improved the renal function, decreased the incidence of adverse reactions certainly.