目的评估阿卡波糖对冠心病合并糖耐量减低患者血管病变的影响。方法入选100例冠心病合并糖耐量减低患者,随机分为2组,观察组采用生活方式干预+阿卡波糖(50~100 mg/次,3次/d),对照组仅生活方式干预。对比两组治疗前后血糖、尿微量蛋白、颈动脉内膜中层厚度变化。结果随访2年后,观察组患者餐后2 h血糖明显降低[(8.95±1.01)vs.(7.52±1.98)mmol/L,P=0.036],对照组患者餐后2 h血糖无明显降低[(8.97±1.15)vs.(8.04±1.51)mmol/L,P=0.067]。观察组颈动脉内膜中层厚度进展明显缓于对照组[(0.06±0.02)vs.(0.23±0.08)mm,P=0.022]。观察组微量蛋白尿发生明显少于对照组(χ2=4.332,P=0.037)。结论阿卡波糖有效降低冠心病合并糖耐量减低患者餐后2 h血糖,延缓动脉粥样硬化。 Objective To evaluate the effect of acarbose on the vascular lesions in patients with coronary heart disease and impaired glucose tolerance. Methods 100 patients with coronary heart disease complicated with impaired glucose tolerance were randomly divided into 2 groups. The lifestyle group was treated with acarbose (50 ~ 100 mg / time, 3 times / d) and the control group only with lifestyle intervention. Before and after treatment, blood glucose, urine microalbumin, carotid artery intima-media thickness changes. Results After 2 years of follow-up, the blood glucose in observation group decreased significantly at 2 h after meal ([8.95 ± 1.01] vs. (7.52 ± 1.98) mmol / L, P = 0.036] (8.97 ± 1.15) vs. (8.04 ± 1.51) mmol / L, P = 0.067]. The carotid artery intima-media thickness in the observation group was significantly slower than that in the control group [(0.06 ± 0.02) vs. (0.23 ± 0.08) mm, P = 0.022]. The incidence of microalbuminuria in the observation group was significantly less than that in the control group (χ2 = 4.332, P = 0.037). Conclusions Acarbose can effectively reduce the blood sugar and postprandial atherosclerosis in patients with coronary heart disease and impaired glucose tolerance.