目的  探究慢性肾衰竭(chronic renal failure，CRF)患者血清上游刺激因子2(upstream stimulatory factor 2，USF2)、硫氧还蛋白相互作用蛋白(thioredoxin interacting protein，TXNIP)、大鼠肉瘤同源基因家族(rat sarcoma homolog gene family，Rho)相关卷曲螺旋形成蛋白激酶2(Rho-associated coiled-coil containing protein kinase 2，ROCK2)水平对血液透析治疗预后的预测价值。 方法  选取2021年1月─2022年12月河北省沧州中西医结合医院首次接受血液透析治疗的CRF患者85例。采用酶联免疫吸附试验测定血清USF2、TXNIP、ROCK2表达水平；Logistic回归分析影响CRF患者预后的因素；受试者工作特征(receiver operating characteristic，ROC)曲线分析血清USF2、TXNIP、ROCK2水平对CRF患者预后的预测价值。 结果  85例CRF患者血液透析治疗后预后不良患者29例(34.12%)，预后良好56例(65.88%)。与良好组相比，不良组患者血清USF2、TXNIP、ROCK2水平升高(t=6.603、7.230、8.731，均P＜0.001)。血清USF2(HR=2.914，95%CI：1.365～6.222，P=0.006)、TXNIP(HR=3.209，95%CI：1.717～5.997，P＜0.001)、ROCK2(HR=2.135，95%CI：1.268～3.596，P=0.004)是影响CRF患者预后的危险因素。血清USF2、TXNIP、ROCK2三者联合预测CRF患者预后的曲线下面积(area under the curve，AUC)最高，优于单独预测(Z三者联合-USF2=3.088、P=0.002，Z三者联合-TXNIP=2.402、P=0.016，Z三者联合-ROCK2=2.872、P=0.004)。 结论  CRF患者血清USF2、TXNIP、ROCK2水平对血液透析治疗预后具有较好的预测价值。

Objective  To explore the predictive value of serum levels of upstream stimulatory factor 2 (USF2), thioredoxin interacting protein (TXNIP), and Rho-associated coiled-coil containing protein kinase 2 (ROCK2) for the prognosis of patients with chronic renal failure (CRF) on hemodialysis.  Methods  A total of 85 CRF patients treated with hemodialysis for the first time in Cangzhou Hospital of Integrated TCM-WH Hebei from January 2021 to December 2022 were recruited as the research subjects. Enzyme linked immunosorbent assay (ELISA) was used to determine serum levels of USF2, TXNIP, and ROCK2. Logistic regression was used to explore the factors affecting prognosis of the CRF patients. Receiver operating characteristic (ROC) curve was used to assess the predictive value of serum levels of USF2, TXNIP, and ROCK2 for prognosis of the CRF patients. Moreover, Hosmer-Lemeshow (H-L) test was used for internal verification of the predictive models.  Results  Among the 85 CRF patient after hemodialysis treatment, 29 (34.12%) had a poorer prognosis, and 56 (65.88%) had a better prognosis. Compared with the better prognosis group, the poorer prognosis group had higher levels of serum USF2, TXNIP, and ROCK2 (t=6.603, 7.230 and 8.731 respectively; P＜0.001). Serum USF2 (HR=2.914, 95% CI: 1.365～6.222, P=0.006), TXNIP (HR=3.209, 95% CI: 1.717～5.997, P＜0.001), and ROCK2 (HR=2.135, 95% CI: 1.268～3.596, P=0.004) were the risk factors affecting prognosis of the CRF patients. The combination of serum USF2, TXNIP, and ROCK2 had higher area under the curve (AUC) than USF2, TXNIP or ROCK2 for predicting prognosis of the CRF patients (Zcombination-USF2=3.088, P=0.002; Zcombination-TXNIP=2.402, P=0.016; Zcombination-ROCK2=2.872, P=0.004).  Conclusion  Serum levels of USF2, TXNIP, and ROCK2 have a better predictive value for the prognosis of CRF patients on hemodialysis.