Aim To study the influence of abnormal glucose tolerance on oxidative stress and endothelial function and heart rate variability in patients with coronary heart disease （CHD） and the intervention effect of acarbose. Methods 60 patients with glucose tolerance abnormal CHD were chosen as group A, and 30 patients with documented stable coronary artery disease and normal glucose tolerance as group B, and fasting blood glucose （FBG）, 2 hours postprandial blood glucose （2hPBG）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDLC）, low density lipoprotein cholesterol （LDLC）, malondialdehyde （MDA） and erythrocyte superoxide dismutase （SOD）, nitric oxide （NO）, endothelin-1 （ET-1） were measured. 24 hours dynamic electrocardiogram （ecg） was used to monitor heart rate variability, and the above indicators were compared. The abnormal glucose tolerance patients with coronary heart disease were randomly divided into control group （30 cases） and treatment group （30 cases）, the control group was given routine therapy for coronary heart disease, the treatment group was given routine therapy for CHD combined with acarbose 50 mg tid, and we observed them for 6 months. We reviewed the test items after 6 months. We compared the above indexes of the two groups before and after treatment, and analyzed the correlation of the above indicators. Results MAD, ET-1 level in group A is significantly increased compared with group B patients. SOD and NO levels in group A is decreased compared with group B patients （P＜0.05）. Heart rate variability （HRV） indexes, SDNN, SDNN5, SDANN of group A are significantly reduced compared with the B group （P＜0.05）, TRIA, PNN50, rMSSD of group A has no statistically significant difference from group B. After carbose treatment for six months, MAD, ET-1 level of treatment group after treatment declined obviously compared with before treatment and the control group after the treatment. SDNN, SDNN5, SDANN of treatment group after treatment significantly increased compared with before treatment and the control group after treatment （P＜0.05）, TRIA, PNN50, rMSSD of treatment group after treatment has no obvious difference compared with before treatment. No obvious difference was found between the indicators before and after treatment in the control group. Changes in the value of HRV indexes before and after treatment and values of MDA, SOD and NO change before and after treatment were positively correlated （correlation coefficient respectively: r＝0.512, r＝0.368, r＝0.420, P＜0.05）. Conclusions Merger of abnormal glucose tolerance in patients with coronary heart disease has more severe vascular endothelial injury and dysfunction of the autonomic nervous function, and oxidative stress participates in the process. After acarbose's treatment， and oxidative stress relieve, endothelial function and autonomic nervous function improve significantly. Acarbose has a therapeutic effect on vascular endothelial function and autonomic nerve function damage in patients with coronary heart disease and abnormal glucose tolerance.