Abstract:

Objective To describe the level of medication adherence and the occurrence of symptoms distress after taking immunosuppressant medication in liver transplantation recipients and explore the relationship between them. Methods A total number of 80 recipients who received liver transplantation from January 2019 to December 2019 in an organ transplantation center of the First Affiliated Hospital of Sun Yat-sen University were included by convenient sampling. The basel assessment scale for immunosuppressive medication adherence and the modified transplant symptom occurrence and symptomdistress scale（MTSOSD）were used to investigate medication adherence，symptom occurrence and disturbance. Results The symptom occurrence score of MSSOSD was 0 ~135（23.38±21.65），and the symptom disturbance score was 0 ~ 134（14.87±22.27）. Difficulties in falling asleep and fatigue were the first and second in the degree of occurrence and disturbance. A total number of 8 cases（10%）of liver transplantation recipients had poor drug compliance. Medication adherence in liver transplantation recipients was associated with the occurrence of immunosuppressant symptoms（P ＝ 0.013，OR ＝ 0.97）. Conclusion Drug-related side effectsare common in liver transplantation recipients taking immunosuppressive medication，and the occurrence of these symptoms affects the medication adherence. The knowledge of drug and compliance should be strengthened in the follow-up of livertransplantation recipients，especially for recipients more than 3 months after operation. It is important to pay attention tothe symptoms of immunosuppressant in liver transplantation recipients and to give timely treatment to improve medication compliance and reduce the occurrence of rejection. 

Key words:

Immunosuppressive medication, Symptom distress, Medication adherence, Liver transplantation

摘要：

目的 描述肝移植受者免疫抑制剂服药依从性情况、服药后症状发生及症状困扰情况，同时探讨肝移植受者服用免疫抑制剂症状发生、症状困扰与服药依从性的关系。方法 本研究采用便利取样，纳入 2019 年 1 月至 2019 年 12 月在中山大学附属第一医院器官移植中心进行肝移植的 80 例受者，采用免疫抑制药物依从性 Basel 评估量表、器官移植患者症状发生和症状困扰量表（modified transplant symptomoccurrence and symptom distress scale，MTSOSD）调查服药依从性及症状发生、困扰情况。结果 MTSOSD症状发生得分 0 ~ 135（23.38±21.65）分，症状困扰得分 0 ~ 134（14.87±22.27）分，其中入睡困难及感到疲劳在发生程度和困扰度上均分别在第 1、第 2 位 ；8 例（10%）肝移植受者服药依从性差 ；肝移植受者服药依从性与免疫抑制剂相关症状的发生相关（P ＝ 0.013，OR ＝ 0.97）。结论 肝移植受者服用免疫抑制剂普遍存在药物相关症状，这些症状的发生影响服药依从性。对术后 3 个月以上肝移植受者随访时，应加强 药物知识及依从性宣教 ；应重视肝移植受者免疫抑制剂相关症状，及时给予处理，提高服药依从性，减少排斥反应的发生。

关键词:

免疫抑制剂 , 症状困扰 , 服药依从性 , 肝移植