[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-110-1-basic-medicine-063":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"lastmod":64},"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-063","nurse-110-1-basic-medicine-063",110,1,63,"下列何者的藥理作用機轉是抑制細胞內微小管（microtubule）的聚合，並具有較低的骨髓抑制作用？",{"A":15,"B":16,"C":17,"D":18},"Colchicine","Docetaxel","Vinblastine","Vincristine","D",null,[],"本題考點在辨識抗微小管抗癌藥的機轉分型與毒性差異。依作用機轉，Vinca生物鹼會結合tubulin、抑制微小管「聚合」而使紡錘體無法形成，Vincristine即屬此類；其劑量限制毒性為周邊神經病變，骨髓抑制相對輕微，故選D。Vinblastine雖同為Vinca生物鹼、機轉相同，但骨髓抑制明顯較強，不符「較低骨髓抑制」；Docetaxel屬紫杉烷類，作用相反，是「穩定」微小管、抑制其解聚，且骨髓抑制顯著；Colchicine雖也抑制微小管聚合，但用於痛風而非抗癌，方向不符。故答案為D。","記憶對比：Vinca生物鹼「阻聚合」、紫杉烷「阻解聚」，兩者一拆一穩卻都停滯於有絲分裂M期。Vincristine與Vinblastine同源卻毒性互補——Vincristine神經毒性強、骨髓毒性弱(V for nerVe)，Vinblastine反之骨髓抑制強(B for Bone marrow)，此對比是考試常見陷阱。Colchicine同抑微小管但臨床用於急性痛風抗發炎。",[25,27,29,31,33],{"term":26,"count":11},"Vinca生物鹼",{"term":28,"count":11},"微小管聚合抑制",{"term":30,"count":11},"紫杉烷類",{"term":32,"count":11},"骨髓抑制",{"term":15,"count":11},[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-110-1-basic-medicine-064","下列何者與磺胺藥（sulfadoxine）混合使用，以治療弓形蟲（Toxoplasma gondii）之感染？",64,{"webId":40,"stem":41,"number":42,"year":10,"session":43},"nurse-110-2-basic-medicine-080","下列何種寄生蟲病診斷時不需要檢查糞便檢體？",80,2,{"webId":45,"stem":46,"number":47,"year":48,"session":43},"nurse-111-2-basic-medicine-014","下列何者具有最低的腎臟血漿清除率（renal clearance）？",14,111,{"webId":50,"stem":51,"number":52,"year":53,"session":11},"nurse-113-1-basic-medicine-012","組成踝關節（ankle joint）的骨骼，除脛骨、腓骨之外還包括：",12,113,{"webId":55,"stem":56,"number":57,"year":58,"session":43},"nurse-114-2-basic-medicine-016","下列何者可將睪固酮轉換為動情二醇（17β-estradiol）？",16,114,{"webId":60,"stem":61,"number":62,"year":63,"session":11},"nurse-106-1-basic-medicine-010","下列何者無軟骨結構？",10,106,"2026-09-04",1788510719684]