T抗原與厭氧細菌感染症

當病人發生厭氧性細菌感染時，有一部份的厭氧菌，會將病人紅血球的T抗原暴露出來，如果用含有T抗體的花生米提煉物，就可以測知T抗原的存在，此時就稱T抗原陽性(T activated)。從民國71年起，到民國74年9月底止，我們共做了300例的檢查，其中100例是屬于健康的損血者，200例是屬於小兒科的病人，在兒科病患中，60例是屬於非感染的病人，另外140例，在住院時，被疑有細菌感染。檢查結果，在100例健康的成人中，T抗原全部陰性，在60例非感染病人裹，僅有1位患呼吸窘迫的早產兒呈陽性反應，共餘59例，均為陰性。另外在140例疑細菌感染羣裹，T抗原陽性共有16位，其中有9例血液培養長出厭氧菌，分別為B. fragilis （4例）, C. perfringens （1例）及Propionibacterium spp. （4例），另外有1例是B. fragilis和嗜氧性細菌的混合感染，其餘6例，雖沒長出厭氧菌，但其中3例為腹腔內感染，與厭氧菌感染有十分密切關係。共餘124例T抗原陰性者，其中有101例血液增減為陰性，23例分別培養出不同的細菌，其中有4例是屬於厭氧菌，其餘均為嗜氧菌，從以上測試結果，得知T抗原在厭氣菌感染者中有76%之陽性率(13/17)，本文僅就T抗原與厭氧菌感染及輸血，血型鏗定等問題，予以討論。

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並列摘要

Normally occult Thomsen antigen (T antigens) on the membranes of red blood cells (RBC) can be exposed by the action of circulating neuraminidase, an enzyme commonly produced by a variety of anaerobic bacteria. These T antigen-exposed red cells can be agglutinated by an extract of Arachis hypogea which possesses anti-T specificity. This kind of polyagglutination is called T-antigen positive or Tactivated. From 1982 to 1985, T-antigen testings were performed in 100 blood donors and in 200 pediatric patients at Mackay Memorial Hospital. Of the 200 patients, 60 patients belonged to the non-infectious group, the other 140 patients were suspected to have infections. T-antigen testings were negative in all 100 blood donors and in the 60 noninfectious patients except for one premature baby with respiratory distress syndrome. However, T-antigen testings were also positive in 16 of those 140 infection suspected patients. Of these 16 patients, blood cultures yielded Propionibacterium in four cases, B. fragilis in five and C. perfringens in one. In the remaining T-antigen-positive, culture-negative 6 cases, the infecting agents were strongly suspected to be anaerobic pathogens, especially in three of them. Among the T-antigen-negative 1247 cases, blood cultures were negative in 101 and anaerobic in 4. In conclusion, T antigen was positive in 13 of 17 (76%) patients with anaerobic infections. The clinical usefulness of determining T antigen to predict the presence of anaerobic infections and avoid blood transfusion reactions is discussed.

並列關鍵字

T antigen ； anaerobic infection ； blood transfusion

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T抗原與厭氧細菌感染症

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