[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-110-1-basic-medicine-058":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"lastmod":65},"基礎醫學","basic-medicine","基礎醫學(包括解剖學、生理學、病理學、藥理學、微生物學與免疫學)",{"id":8,"webId":9,"year":10,"session":11,"subject":4,"number":12,"stem":13,"options":14,"answer":19,"answerNote":20,"images":21,"explanation":22,"explanationDeep":23,"topics":24,"freq":11},"nurse-110-1-基礎醫學-058","nurse-110-1-basic-medicine-058",110,1,58,"Alteplase 主要用於治療急性缺血性中風、心肌梗塞、肺栓塞、深部靜脈栓塞，其藥理作用機轉為何？",{"A":15,"B":16,"C":17,"D":18},"不可逆結合抑制凝血酶 IIa","可逆結合抑制凝血酶 Xa","活化已經和血栓結合之胞漿素原（fibrin-bound plasminogen）","活化 vitamin K 環氧化還原酶（epoxide reductase）","C",null,[],"本題考點是血栓溶解劑 alteplase 的作用機轉。依藥理學,alteplase 是組織型胞漿素原活化劑,能選擇性活化「已與血栓結合」的 plasminogen 使其轉為胞漿素,進而分解纖維蛋白溶解血栓,故選 C。考點在於分清抗凝與溶栓機轉:A 不可逆抑制凝血酶 IIa 描述的是直接凝血酶抑制劑;B 可逆抑制凝血因子 Xa 是新型口服抗凝劑的機轉;D 活化維生素 K 環氧化還原酶方向相反(warfarin 是抑制此酶),三者皆為抗凝而非溶栓,唯 C 為 tPA 的溶栓機轉。","溶栓與抗凝要分家:抗凝劑(heparin、warfarin、DOACs)是「防止新血栓形成」,溶栓劑(alteplase、streptokinase)則「溶解已形成的血栓」。tPA 的優點是對結合於纖維蛋白的胞漿素原具選擇性,理論上較不引發全身性纖溶,但仍有顯著出血風險,故急性缺血性中風有嚴格的時間窗與禁忌評估。記憶法:tPA = 溶血栓的鑰匙,plasmin 是真正的剪刀。",[25,27,29,31,33],{"term":26,"count":11},"alteplase",{"term":28,"count":11},"組織型胞漿素原活化劑",{"term":30,"count":11},"胞漿素",{"term":32,"count":11},"纖維蛋白溶解",{"term":34,"count":11},"血栓溶解劑",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-110-1-basic-medicine-059","Nitroglycerin（NTG）經由舌下或經皮膚（貼劑）給藥的目的為何？",59,{"webId":41,"stem":42,"number":43,"year":10,"session":44},"nurse-110-2-basic-medicine-075","關於萊姆病（Lyme disease）及其病原體的敘述，下列何者錯誤？",75,2,{"webId":46,"stem":47,"number":48,"year":49,"session":44},"nurse-111-2-basic-medicine-009","下列何者是由勃起組織（erectile tissue）構成，與男性的陰莖（penis）有相似的構造，受刺激時會充血勃起？",9,111,{"webId":51,"stem":52,"number":53,"year":54,"session":11},"nurse-113-1-basic-medicine-007","下列何者最可能同時降低動脈血壓波振幅（arterial pulse wave）與動脈血壓波速度（pulse wave velocity）？",7,113,{"webId":56,"stem":57,"number":58,"year":59,"session":44},"nurse-114-2-basic-medicine-011","次級主動運輸（secondary active transport）的直接動力來自：",11,114,{"webId":61,"stem":62,"number":63,"year":64,"session":11},"nurse-106-1-basic-medicine-005","下列何者是維持背部直立最重要的肌肉？",5,106,"2026-09-04",1788510719636]