OBJECTIVE： To observe the efficacy and safety of alprostadil combined with tanshinone ⅡA in the treatment of patients with early chronic kidney disease （ECKD）. METHODS： 138 ECKD patients were randomly divided into group A， group B and group C， 46 cases in each group. On the basis of conventional treatment， group A received 40 mg Tanshinone ⅡA sodium sulfonate injection， adding into 250 ml 0.9％ Sodium chloride solution， ivgtt， qd+10 μg Alprostadil injection， adding into 100 ml 0.9％ Sodium chloride solution， ivgtt， qd； group B received the same dose with Alprostadil injection； group C received the same dose with Tanshinone ⅡA sodium sulfonate injection. All patients were treated for 14 d. Clinical efficacy， laboratory indexes [24 h urine protein， serum creatinine （SCr）， total cholesterol （TC）， triglyceride （TG）， blood urea nitrogen （BUN）， uric acid （UA）] in 3 groups before and after treatment were observed， and the incidence of adverse reactions was compared. RESULTS： The total effective rate in group A was 97.83％， which was significantly higher than group B （80.43％） and group C （76.09％）， the differences were statistically significant （P＜0.05）. Before treatment， there were no significant differences in 24 h urine protein， SCr， TC， TG， BUN and UA among 3 groups （P＞0.05）； after treatment， all above-mentioned indexes significantly reduced， and group A was lower than group B and group C， the differences were statistically significant （P＜0.05）. There was no significant difference in the incidence of adverse reactions among group A （10.87％）， group B （6.52％） and group C （8.70％） （P＞0.05）. CONCLUSIONS： Alprostadil combined with tanshinone ⅡA shows good efficacy in the treatment of ECKD， it can improve renal function in patients with good safety.