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Objective To observe the changes of the glycolipid and coronary artery lesions in coronary artery disease patients with isolated post-challenge hyperglycaemia (IPH). Methods Hospitalized coronary artery disease patients diagnosed by coronary angiography were received oral glucose tolerance test. The labarotary test datas, including blood hematochrome, fasting and post-challenge plasma glucose levels, plasma lipid and insulin levels, were recorded. The number of diseased coronary artery and coronary lesion scores were calculated according to coronary angiogram for each patient. Continuous 77 patients with normal glucose metabolism(normal glucose metabolism group) and 104 patients with IPH (IPH group) entered the study. Results The occurrence of hypertension, acute coronary syndrome, multivessel coronary disease, revascularization were 84.6%(88/104), 82.7%(86/104), 69.2%(72/104), 70.2%(73/104) in IPH group and 63.6%(49/77), 70.1%(54/77), 50.6%(39/77), 54.5%(42/77) in normal glucose metabolism group, and there were significant differences(χ2=3.985-10.583, all P<0.05). The body mass index, triglyceride, total cholesterol, fasting glucose, post-challenge glucose, hemoglobin A1c, fasting insulin, insulin resistance index, coronary lesion scores were (27.42±3.55) kg/m2,(2.18±1.53) mmol/L,(4.73 ± 1.00) mmol/L,(5.98 ± 0.92) mmol/L, (14.11 ± 1.94) mmol/L, (5.90 ± 0.78)%, (10.07 ± 6.13) mU/L, 2.617 ± 1.535, (41.35 ± 27.21) points in IPH group and (25.11 ± 3.40) kg/m2, (1.52 ± 0.85) mmol/L, (4.22 ± 1.02) mmol/L, (5.24±0.62) mmol/L, (6.49±1.07) mmol/L, (4.97±0.39)%, (7.72±4.28) mU/L,1.785±0.974, (33.36±23.36) points in normal glucose metabolism group, and there were significant differences(t=3.035-33.698, P<0.05 or 0.01). Conclusions Coronary artery disease patients with IPH have much more seriously abnormal glycolipid metabolism and complex coronary artery lesions, and need specialized nursing management.