我国接受心血管植入型电子器械治疗的老年患者磁共振检查的需求调查

Demand of magnetic resonance imaging examination in elderly people with cardiovascular implantable electronic devices： a survey in China

目的回顾性调查我国接受心血管植入型电子器械（CIED）治疗的老年患者对磁共振（MRI）检查的真实需求,为相关的医疗实践提供参考.方法回顾性问卷调查2010年至2012年间国内8家具有独立心律失常亚专业的综合性三级甲等医院共950例,年龄≥65岁,且已接受CIED治疗的患者,每人接受10个与MRI检查相关的问题.结果950例患者的平均年龄（77＆#177;10）岁,其中男536例（56.4％）.植入CIED前,247例（26％）曾接受过MRI检查.在植入CIED后平均（2.3＆#177;1.1）年的随访期中,131例（14％）患者被告知有必要进行MRI检查,其中57例（6％）为术前曾接受MRI检查者.因此,CIED术前和术后累计具有MRI检查真实需求的患者为321例（33.8％）.332例（34.9％）患者对因体内存在CIED而无法接受MRI检查表达了担心.493例（52％）患者计划在未来CIED更换时选择能接受MRI检查的设备.人民币7万元以下被认为是MRI相容起搏器的合理价格.结论在我国大中城市,具有CIED适应证的老年人群具有较高的MRI检查需求.

Objective To investigate the real demand of magnetic resonance imaging （MRI） examination in elderly patients who had been treated with cardiac implantable electronic device（CIED） in China.Methods In this retrospective questionnaire survey,950 elderly patients （age ≥65 years） treated with CIED in eight tertiary arrhythmia centers from 2010 to 2012 were included.The questionnaire comprised of 10 questions regarding MRIexamination.Results Of the 950 patients [age （77＆#177; 10） years,536 males],247 （26%） underwent MRI examination before CIED treatment.After CIED treatment,131 （14%） cases had a clear MRI indication within a mean follow-up period of（2.3＆#177; 1.1） years,in whom 57 （6%） had underwent MRI examination before CIED treatment.Therefore,totally 321 （33.8%）patients had the real demand of MRI examination in this group.Three hundreds and thirty-two（34.9%）patients concerned the fact that CIED is a contraindication for MRIexamination and 493 （52%） claimed that they would choose MRI compatible CIED in the future replacement procedures.Renminbi 70,000 yuan or less was considered a reasonable price for a MRI compatible pacemaker in 62.3% patients.Conclusions Among elderly patients treated with CIED who lived in the first or second tier cities in China,the real demand for MRIcompatible CIED is high.