目的 探讨葡萄糖调节蛋白78（GRP78）在哮喘炎症及病情监测中的作用，分析GRP78与Th1、Th2、Th17细胞因子及肺功能指标FEV₁%、FEV₁/FVC%的相关性。 方法 纳入115例哮喘患者（其中轻度哮喘57例、中度哮喘47例和重度哮喘11例）和42例健康对照。通过ELISA检测血清GRP78、IL-4、IL-13、IL-17和IFN-γ水平，同时收集肺功能指标FEV₁%、FEV₁/FVC%进行综合分析。 结果 血清GRP78在哮喘患者组的水平显著高于正常对照组（P < 0.01），且水平随着病情严重程度增加而升高，轻、中、重度哮喘组GRP78水平分别为（23.42 ± 0.12）ng/mL、（28.01 ± 0.03）ng/mL 和（33.33 ± 0.14）ng/mL，均高于对照组的（16.38 ± 0.11）ng/mL（P < 0.05）；哮喘患者中血清IL-4、IL-13、IL-17水平［分别为（2 754.07 ± 7.32）pg/mL， （2 490.72 ± 41.32）pg/mL， （7 080.38 ± 546.32）pg/mL］显著高于正常对照组［分别为（1 493.44 ± 344.32）pg/mL，（1 280.18 ± 20.43）pg/mL，（3 668.92 ± 321.51）pg/mL］（P < 0.01），而IFN-γ的水平［（652.90 ± 42.67） pg/mL］低于正常对照组［（110 1.3 ± 111.42） pg/mL］（P < 0.01）；Pearson相关分析显示，GRP78与IL-13、IL-17水平呈正相关（IL-13：r = 0.34， P < 0.05；IL-17：r = 0.26， P < 0.05），与IFN-γ水平、FEV₁%、FEV₁/FVC%呈负相关（IFN-γ：r = -0.31， P < 0.05；FEV₁%：：r = -0.21， P < 0.05；FEV₁/FVC%：r = -0.32， P < 0.05）。 结论 哮喘患者中血清GRP78水平显著升高，且随着病情严重程度的加重而升高；血清GRP78有望成为评估哮喘病情和预后的新型生物标志物。

Objective To assess the potential of GRP78 as a clinical biomarker in asthma by evaluating its relationship with key inflammatory cytokines and pulmonary function. Methods A total of 115 asthma patients （including 57 with mild， 47 with moderate， and 11 with severe asthma） and 42 healthy controls were enrolled. Serum levels of GRP78， IL-4， IL-13， IL-17， and IFN-γ were measured using ELISA. Pulmonary function parameters， including FEV1% and FEV1/FVC%， were also collected for comprehensive analysis. Results The level of serum GRP78 in the asthma patient group was significantly higher than that in the normal control group （P < 0.01）， and it increased with the severity of the disease. The levels of GRP78 in the mild， moderate and severe asthma groups were （23.42 ± 0.12） ng/mL， （28.01 ± 0.03） ng/mL and （33.33 ± 0.14） ng/mL respectively， all of which were higher than that in the control group （16.38 ± 0.11） ng/mL （P < 0.05）. The levels of serum IL-4， IL-13 and IL-17 in asthma patients ［（2 754.07 ± 7.32） pg/mL， （2 490.72 ± 41.32） pg/mL， （7 080.38 ± 546.32） pg/mL respectively］ were significantly higher than those in the normal control group ［（1 493.44 ± 344.32） pg/mL， （1 280.18 ± 20.43） pg/mL， （3 668.92 ± 321.51） pg/mL respectively］ （P < 0.01）， while the level of IFN-γ ［（652.90 ± 42.67） pg/mL］ was lower than that in the control group ［（1 101.3 ± 111.42） pg/mL］ （P < 0.01）. Pearson correlation analysis showed that GRP78 was positively correlated with the levels of IL-13 and IL-17 （IL-13： r = 0.34， P < 0.05； IL-17： r = 0.26， P < 0.05）， and negatively correlated with the levels of IFN-γ， FEV1% and FEV1/FVC% （IFN-γ： r = -0.31， P < 0.05； FEV1%： r = -0.21， P < 0.05； FEV1/FVC%： r = -0.32， P < 0.05）. Conclusions Serum GRP78 is elevated in asthma and correlates with disease severity， Th2/Th17 inflammation， and impaired lung function. These findings support its potential utility as a clinically relevant biomarker for asthma evaluation and monitoring.