【摘要】目的探讨简化服药依从性问卷(simplified medication adherence questionnaire，SMAQ)在提高维持性血液透析患者口服磷结合剂依从性中的效果。方法选择2018 年1 月～12 月辽宁省丹东市第一医院收治的95 例维持性血液透析合并高磷血症患者，根据随机数字表法分为SMAQ 组(n=46例)和对照组(n=49 例)，2 组均口服磷结合剂治疗并实施常规护理，SMAQ 组应用SMAQ 问卷干预，干预周期为3 个月，对干预前后2 组血磷达标率、血钙、血磷、钙磷乘积、全段甲状旁腺激素(intact parathyroid hormone,iPTH)水平及不良反应发生率进行比较。结果①SMAQ 组问卷评分干预后较干预前提高(χ2=32.687,P＜0.001)；②干预后，SMAQ 组血磷达标率较干预前提高(χ2=28.599,P＜0.001)，血磷(t=6.350，P＜0.001)、钙磷乘积(t=6.202,P＜0.001)较前改善，iPTH 存在改善趋势(430.2 pg/ml 比543.2 pg/ml, t=1.703，P=0.095)；③干预后，SMAQ 组的血磷(t=-2.956,P=0.004)、钙磷乘积(t=-2.744，P=0.007)明显低于对照组，iPTH 水平(430.2pg/ml)存在低于对照组趋势(543.8pg/ml, t=-1.287，P=0.201)，血钙2 组间无统计学差异(t= -0.261, P=0.795)。结论在维持性血液透析患者中应用SMAQ 问卷干预，可有效提高口服磷结合剂依从性。

【Abstract】Objective To investigate the effect of the simplified medication adherence questionnaire (SMAQ) in improving treatment compliance with oral phosphorus binding-agent in maintenance hemodialysis (MHD) patients. Methods A total of 95 MHD patients complicated with hyperphosphatemia and admitted to Dandong First Hospital in the period from January 2018 to December 2018 were enrolled in this study. According to the random number table method, they were divided into the SMAQ group (n=46) and the control group (n=49). Both groups were treated with oral phosphorus binding agent and routine nursing. Patients in the SMAQ group were treated with SMAQ during nursing process and the intervention lasted 3 months. Serum phosphorus (SP) control rate, serum calcium (SCa), serum phosphorus (SP), calcium-phosphorus product (Ca×P), intact parathyroid hormone (iPTH) and adverse reactions were compared between the groups before and after the intervention. Results After the intervention, the SMAQ scores were significantly improved (χ2=32.687, P＜0.001), SP control rate was higher in the SMAQ group than in the control group (χ2=28.599, P＜0.001), SP (t=-2.956, P=0.004) and Ca×P value (t=-2.744, P=0.007) were lower in the SMAQ group than in the control group, and iPTH was also lower in the SMAQ group than in the control group but without statistical significance (430.2 pg/ml vs. 543.8 pg/ml; t=-1.287, P=0.201). SCa was similar between the two groups (t= -0.261, P=0.795). Conclusion The application of SMAQ among MHD patients can effectively improve their compliance with oral phosphorus-binding agent.