【摘要】 目的 探讨心血管病高危人群总胆固醇/高密度脂蛋白胆固醇比值(TC/HDL-C)对颈动脉粥样硬化的影响，为颈动脉粥样硬化的早期防治提供科学依据。方法 2015—2016年在江苏省6个心血管病高危人群早期筛查与综合干预项目点进行身体测量、颈动脉超声检查、实验室检测和问卷调查，使用多因素logistic回归模型分析TC/HDL-C与颈动脉粥样硬化的关联。结果 11 392名调查对象中，男性、在婚、吸烟、高学历、高家庭收入、血压正常者、高血糖、高体质指数和低年龄的调查者TC/HDL-C更高，差异有统计学意义(χ~2/F值为20.31～1 152.93,P值均<0.01)。多因素线性和logistic回归分析显示，TC/HDL-C(β=0.005,P<0.01)与颈动脉内中膜厚度(cIMT)呈正线性关系；TC/HDL-C每变化一个单位，颈动脉异常和斑块的患病风险分别升高8%(OR=1.08,95%CI:1.04～1.11)和5%(OR=1.05,95%CI:1.02～1.08)。分层分析结果显示，与血压正常人群相比，在高血压人群中颈动脉异常患病风险更高(OR=1.10 vs.OR=0.96,交互作用检验P<0.01)。结论 在心血管病高危人群中，TC/HDL-C与颈动脉粥样硬化呈正相关，尤其是在高血压人群中的正相关性更强。更多还原

【Abstract】 Objective To explore the effect of TC/HDL-C on carotid atherosclerosis in population with high risk for cardiovascular diseases, and provide scientific basis for early prevention and treatment of carotid atherosclerosis. Methods From 2015 to 2016,physical measurements, carotid ultrasound examination, laboratory tests, and questionnaire surveys were conducted at six Programme of Screening and Intervention Subjects with High Risk Cardiovascular Diseases sites in Jiangsu Province, multivariate logistic regression models were performed to analyze the relationship between TC/HDL-C and carotid atherosclerosis. Results In the 11 392 participants, male, married, smoking, higher education, higher household income, normal blood pressure, higher blood glucose, higher body mass index, and younger age had higher TC/HDL-C,the differences were statistically significant(χ~2/F values were from 20.31 to 1 152.93,P<0.01 for all).Multivariate linear regression model analysis showed a positive linear relationship between TC/HDL-C(β=0.005,P<0.01) and cIMT,and multivariate logistic regression model analysis demonstrated that for every unit change in TC/HDL-C,the risk of abnormal carotid artery and carotid plaque increases by 8%(OR=1.08,95% CI: 1.04～1.11) and 5%(OR=1.05,95% CI: 1.02～1.08),respectively.Stratified analysis showed that compared to population with normal blood pressure, those with hypertension(OR=1.10 vs.OR=0.96,interaction test P<0.01) had a higher risk of developing abnormal carotid artery. Conclusion TC/HDL-C is positively correlated with carotid atherosclerosis in population with high risk for cardiovascular diseases, especially in the hypertension population.更多还原