目的研究阿卡波糖对冠心病合并糖耐量减低患者长期预后的治疗作用。方法选取上海市静安区市北医院100例冠心病合并糖耐量减低患者,随机分为两组,每组50例:观察组(阿卡波糖150mg/d),对照组(无阿卡波糖),所有患者给予冠心病基础治疗及生活方式干预,随访2年。观察两组治疗前后血糖变化、心血管事件发生。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)mmol/L vs(7.52±1.98)mmol/L,P=0.036],对照组患者餐后2 h血糖降低差异无统计学意义[(8.97±1.15)mmol/L vs(8.04±1.51)mmo/L,P=0.067],观察组患者并发2型糖尿病发生率明显少于对照组(6.00%vs20.00%,χ~2=6.492,P=0.011),观察组与对照组总心血管事件发生率差异无统计学意义(24.00%vs36.00%,χ~2=1.714,P=0.190)。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,阻止2型糖尿病发生。 Objective To study the therapeutic effect of acarbose on long-term prognosis of patients with coronary heart disease complicated with impaired glucose tolerance. Methods One hundred patients with coronary heart disease complicated with impaired glucose tolerance in Shanghai North Hospital of Jing’an District of Shanghai were randomly divided into two groups with 50 patients in each group: acarbose 150mg / d in the observation group, ), All patients were given basic treatment of coronary heart disease and lifestyle intervention, followed up for 2 years. Before and after treatment, the changes of blood glucose and cardiovascular events were observed. Results After 2 years of follow-up, the blood glucose in observation group decreased significantly at 2 h after meal ([8.95 ± 1.01] mmol / L vs (7.52 ± 1.98) mmol / L, P = 0.036] (8.97 ± 1.15 mmol / L vs 8.04 ± 1.51 mmo / L, P = 0.067). The incidence of type 2 diabetes mellitus in observation group was significantly lower than that in control group (6.00% vs20.00%, P < χ ~ 2 = 6.492, P = 0.011). There was no significant difference in the total incidence of cardiovascular events between the observation group and the control group (24.00% vs36.00%, χ ~ 2 = 1.714, P = 0.190). Conclusions Acarbose can effectively reduce the blood glucose in patients with coronary heart disease complicated with impaired glucose tolerance and reduce the occurrence of type 2 diabetes.