馬偕紀念醫院病人異體抗體的頻率

Frequency of Alloantibodies in Patients in Mackay Memorial Hospital

此篇報告是針對馬偕醫院台北院區於2002年5月1日到2002年10月31日半年期間需要輸血（備血）的3671個病患所作的調查，結果發現共有96例病患帶異體抗體，所以台灣的病人帶異體抗體的頻率為2.7%（96/3671），其中83例是溫型（臨床上有意義）抗體。此期間來院第一次備血就發現有抗體的病人有77例，即2.1%（77/3671）。在這六個月中共有1004個病患血2次以上，而於第2次以後的備血才發現帶有異體抗體者22例，頻率為2.2%（22/1004），表示係由上次輸血引發的。這96例病人的抗體包括45例“Mia”抗體及38例Rh血型系統抗體，因此anti-“Mia”佔一半以上，而且anti-“Mia”在總輸血人口中為最常見的，其出現頻率為1.2%（45/3617），所以台灣最重要的異體抗體是anti-“Mia”。這45例anti-“Mia”有84%為37℃反應，過去的經驗這抗體可引起新生兒溶血性疾病及血管內溶血的輸血反應。在38例Rh血型系統的抗體中anti-E有34例，但anti-D只有2例。由引結果可看anti-D佔Rh血型系統抗體的頻率只有5%（2/38）。和1988年之前我們有做病人RhD血型篩檢時anti-D頻率一樣，顯示anti-D在國內並不重要。

In the course of a six month period (May to October 2002)of antibody screening by manual Polybrene method at the Mackay Memorial Hospital Taipei 96 patients(2.7%)from 3617 transfused patients ere found to carry alloantibodies, among these 96 patients 77 patients ere found to carry alloantibody at the initial transfusion(2.1%). During this period, 1004 patients from the same cohort were transfused at least twice, 22 patients developed alloantibodies, showing a frequency of recent alloimmurnzation and anamnestic immune response of 2.2% (22/1004). Alloantibodies encountered in 96 patients included 45 cases anti-“Mi(superscript a)” and 38 cases with alloantibodies against Rh blood group system Therefore the frequency of anti-“Mi(superscript a)” among transfused patients vas 1.2% (45/3617). Since most (83%) anti-“Mi(superscript a)” were also warm reacting indicating anti-“Mi(superscript a)” is the most important alloantibody in Taiwan. Among 38 cases with alloantibodies against Rh blood group system. 34 cases were anti-E, and only 2 cases were anti-D. The incidence of anti-D in our hospital after 1988 remained the same as before 1988 when there vas routine RhD typing.