OBJECTIVE: To probe into the effects of alprostadil combined with insulin degludec in the treatment of lower extremity vascular disease with type 2 diabetes mellitus based on balance of oxidation/antioxidation and changes of microRNA（miR）-221 and miR-155 levels. METHODS: Totally 94 patients with lower extremity vascular disease with type 2 diabetes mellitus admitted into the hospital from Dec. 2018 to Dec. 2020 were extracted to be divided into the observation group（n=47） and the control group（n=47） via the simple randomization. Both groups were treated with basic treatment

the control group was treated with insulin degludec

and the observation group received alprostadil combined with insulin degludec. The efficacy

adverse drug reactions and clinical symptoms scores

ankle-brachial indicator（ABI）

lower extremity arteries（posterior tibial artery

dorsal artery and popliteal blood flow and inner diameter of femoral artery）

serum oxidative stress indicators[8 isoprostaglandin F2α（8-iso-PGF2α）

superoxide dismutase（SOD）

oxidized low-density lipoprotein（ox-LDL）]

miR-221

miR-155 levels before and after treatment were compared between two groups. RESULTS: The total effective rate of the observation group was 95.74%（45/47）

significantly higher than 80.85%（38/47） of the control group

the difference was statistically significant（P<0.05）. After treatment

the clinical symptom score of the observation group was lower than the control group

ABI value was higher than the control group

blood flow of posterior tibial artery

dorsal foot artery

popliteal artery and femoral artery were higher than the control group

and inner diameter were longer than the control group

the differences were statistically significant（P<0.05）. After treatment

the serum levels of 8-iso-PGF2α

ox-LDL

miR-221 and miR-155 in the observation group were lower than those in the control group

while the level of serum SOD was higher than that in the control group

the differences were statistically significant（P<0.05）. The incidence of adverse drug reactions in the observation group and control group was respectively 8.51%（4/47） and 6.38%（3/47）

with no statistically significant difference（P>0.05）. CONCLUSIONS: Alprostadil combined with insulin degludec in the treatment of lower extremity vascular disease with type 2 diabetes mellitus can adjust the balance of oxidation/antioxidation

reduce the levels of serum miR-221 and miR-155

increase the inner diameter of lower extremity arteries and blood flow

improve the clinical symptoms with significant effects.