[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-108-1-medical-surgical-057":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"內外科護理學","medical-surgical",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":25},"nurse-108-1-內外科護理學-057","nurse-108-1-medical-surgical-057",108,1,57,"下列何者最容易造成 α 1 -抗胰蛋白酶（α 1 -antitrypsin）缺乏？",{"A":14,"B":15,"C":16,"D":17},"慢性支氣管炎","肺氣腫","氣喘","支氣管擴張症","B",null,[],"本題考點在於 α1-抗胰蛋白酶缺乏所致的肺部病變。α1-抗胰蛋白酶是抑制彈性蛋白酶的保護性酵素，缺乏時肺泡彈性蛋白被過度分解、肺泡壁破壞而失去彈性回縮，形成肺氣腫，故選 B。（A）錯在慢性支氣管炎主因為長期吸菸與慢性刺激造成黏液腺增生，與抗胰蛋白酶缺乏無直接因果。（C）錯在氣喘為可逆性氣道過度反應與發炎，機轉屬過敏／高反應性，非蛋白酶失衡。（D）錯在支氣管擴張症源於反覆感染破壞支氣管壁彈性支撐，非酵素缺乏所致。","核心是「蛋白酶—抗蛋白酶失衡」：嗜中性球釋放的彈性蛋白酶會分解肺泡彈性蛋白，α1-抗胰蛋白酶負責抑制之。遺傳性缺乏（尤其 PiZZ 型）或吸菸使抗蛋白酶失活，皆使肺泡壁遭破壞形成全小葉型肺氣腫，且常見於年輕、非吸菸或有家族史者，可合併肝硬化。記憶口訣：「少了保鑣（抗胰蛋白酶），彈力牆被拆（肺氣腫）」。連結概念：彈性蛋白酶、全小葉型肺氣腫、PiZZ 基因型、吸菸氧化失活。",[24,26,29,31,33],{"term":15,"count":25},5,{"term":27,"count":28},"肺泡壁破壞",2,{"term":30,"count":10},"α1-抗胰蛋白酶缺乏",{"term":32,"count":10},"蛋白酶抗蛋白酶失衡",{"term":34,"count":10},"彈性蛋白酶",[36,40,44,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-108-1-medical-surgical-058","慢性阻塞性肺部疾病病人最早出現的肺功能變化為下列何者？",58,{"webId":41,"stem":42,"number":43,"year":9,"session":28},"nurse-108-2-medical-surgical-074","有關水分剝削試驗（Water Deprivation Test）之敘述，下列何者錯誤？",74,{"webId":45,"stem":46,"number":47,"year":48,"session":28},"nurse-109-2-medical-surgical-008","陳先生早上騎機車出門上班時，於十字路口與計程車擦撞倒地，同時頭部撞到地面，當時意識清楚但有多處擦傷及撕裂傷，由救護車送至急診室，當醫師正在縫合傷口時，陳先生突然喪失意識，其最大可能為下列何種頭部創傷？",8,109,{"webId":50,"stem":51,"number":52,"year":53,"session":28},"nurse-110-2-medical-surgical-046","有關蜂窩性組織炎病人的護理措施，下列何者錯誤？",46,110,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-112-1-medical-surgical-010","進行內視鏡逆行性膽胰攝影檢查，若導管不易進入總膽管，可使用下列何種藥物讓歐迪氏括約肌（sphincter of Oddi）鬆弛？",10,112,{"webId":60,"stem":61,"number":62,"year":58,"session":63},"nurse-112-3-medical-surgical-044","有關中樞性尿崩症的敘述，下列何者正確？",44,3,"2026-09-04",1788510710022]