中文摘要：

目的通过观察阻塞性睡眠呼吸暂停（OSA）患者血清葡萄糖调节蛋白78（GRP78）水平，探讨内质网应激在OSA病理生理学变化中的作用。方法选91例OSA患者（轻度30例，中度28例，重度33例）及27例单纯肥胖者行多导睡眠监测，包括睡眠呼吸暂停低通气指数（AHI）、最低动脉血氧饱和度（SaO2）、氧饱和度≤90％时间占总监测时间百分比（SIT90），其中11例中重度OSA患者给予持续气道内正压（CPAP）通气治疗1d。多导睡眠监测第2天清晨抽血采用ELISA测血清GRP78水平。结果轻度[（3．42±0．97）μg/L]、中度[（2．67±1．14）μg/L]、重度[（2．62±1．11）μg/L]OSA患者血清GRP78水平明显高于单纯肥胖者[（1．75±0．41）μg／L；P〈0．05]。与中、重度OSA患者比，轻度OSA患者血清GRP78水平升高更为明显（P〈0．05）。11例中、重度OSA患者给予CPAP通气治疗1d后，血清GRP78水平较治疗前显著降低[（1．77±0．39）μg/L比（2．84±0．39）μg/L；P〈0．05]。结论OSA患者存在内质网应激，随病情加重OSA患者血清GRP78水平呈先升后降的变化趋势。

英文摘要：

Objective This study aimed to detect serum level of glucose regulated protein 78 （GRP78） in patients with obstructive sleep apnea（OSA） and explore the relationship between endoplasmic retieulum stress and the pathophysiology of OSA. Methods A total of 91 patients with OSA were enrolled in this study, including 30 mild, 28 moderate and 33 severe. The other 27 obese subjects were of age, gender and BMI matched group. Eleven moderate or severe OSA patients were administrated with continuous positive airway pressure （CPAP） treatment for 24 hours. Polysomnography, apnea hypopnea index （ AHI ） , lowest arterial oxygen saturation（SaO2） and percentage of time spent at SaO2 below 90% （SIT90） were measured before and after sleep. Serum GRP78 was measured by ELISA. Results The expression of GRP78 in mild （ 3.42±0.97 ）μg/L, moderate （ 2.67±1. 14 ）μg/L and severe （ 2.62±1. 11 ） μg/L OSA groups was significantly higher than in control group（ 1.75 ± 0.41 ） μg/L （ P 〈 0.05 ）. The GRP78 level in mild OSA group was significantly higher than either moderate or severe OSA group （ P 〈 0.05 ）. After 24 h treatment of CPAP, serum GRP78 level decreased significantly [ （ 1.77 ± 0.39 ） μg/L vs （ 2.84 ± 0.39 ） μg/L; P 〈 0.051. Conclusions Endoplasmic retieulum stress involves in the pathophysiology of patients with OSA. Higher GRP78 level in mild OSA patients suggests that endoplasmic reticulum related protein GRP 78 might rise then fall during exacerbation of OSA.