[{"data":1,"prerenderedAt":68},["ShallowReactive",2],{"q-nurse-110-2-basic-medicine-053":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"lastmod":67},"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":27},"nurse-110-2-基礎醫學-053","nurse-110-2-basic-medicine-053",110,2,53,"免疫抑制劑 mycophenolate mofetil 用於腎臟移植時，可減少淋巴細胞異常增殖而緩解腎臟排斥作用，其作用機轉為何？",{"A":15,"B":16,"C":17,"D":18},"抑制 purine 的生合成","抑制 calcineurin 的活性","螯合 DNA 的作用","抑制轉錄因子 NFAT 的活性","A",null,[],"本題考點為免疫抑制劑 mycophenolate mofetil（MMF）的分子作用機轉。依其藥理，MMF 於體內水解為 mycophenolic acid，選擇性抑制 inosine monophosphate dehydrogenase（IMPDH），阻斷嘌呤（purine）的 de novo 合成路徑；淋巴細胞缺乏補救合成途徑而特別依賴此路徑，增殖因而被壓制、緩解移植排斥，故選 A。B 抑制 calcineurin 是 cyclosporine 與 tacrolimus 的機轉；D 抑制轉錄因子 NFAT 亦屬 calcineurin 訊息下游，兩者皆非 MMF 所為；C 螯合 DNA 並非其作用方式。","IMPDH 是嘌呤 de novo 合成的限速酵素，T、B 淋巴細胞的鳥嘌呤核苷酸供應幾乎全靠此路徑，這正是 MMF 具淋巴細胞選擇性、骨髓與腸道以外毒性較低的原因。記憶對比：calcineurin 抑制劑（cyclosporine、tacrolimus）阻斷 NFAT 去磷酸化而抑制 IL-2 轉錄；MMF 走的是核苷酸合成這條完全不同的路。可連結概念：de novo 與 salvage 兩條嘌呤合成路徑、azathioprine 亦作用於嘌呤代謝，適合一起對照複習移植三合一用藥。",[25,28,30,32,34],{"term":26,"count":27},"mycophenolate mofetil",1,{"term":29,"count":27},"IMPDH",{"term":31,"count":27},"嘌呤 de novo 合成",{"term":33,"count":27},"淋巴細胞選擇性",{"term":35,"count":27},"calcineurin 抑制劑",[37,41,46,51,56,62],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-110-2-basic-medicine-054","如果一個藥物的半衰期為 10 小時，以靜脈輸注此藥物後，在血液中達到穩定濃度所需的時間約多久？",54,{"webId":42,"stem":43,"number":44,"year":45,"session":27},"nurse-111-1-basic-medicine-070","下列何者是主要引起敗血症全身性反應的因子？",70,111,{"webId":47,"stem":48,"number":49,"year":50,"session":27},"nurse-112-1-basic-medicine-034","甲、乙、丙三種藥物作用在相同受體，其濃度與藥理作用曲線圖如下，下列敘述何者正確？",34,112,{"webId":52,"stem":53,"number":54,"year":55,"session":11},"nurse-113-2-basic-medicine-032","有關全身性麻醉劑 propofol，下列敘述何者正確？",32,113,{"webId":57,"stem":58,"number":59,"year":60,"session":61},"nurse-114-3-basic-medicine-036","下列利尿劑（diuretics）中，何者為醛固酮受體（aldosterone receptor）拮抗劑，常用於治療心衰竭？",36,114,3,{"webId":63,"stem":64,"number":65,"year":66,"session":27},"nurse-106-1-basic-medicine-080","下列有關廣東住血線蟲（Angiostrongylus cantonensis）之敘述，何者正確？",80,106,"2026-09-04",1788510727782]