[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-111-1-basic-medicine-037":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":33,"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-111-1-基礎醫學-037","nurse-111-1-basic-medicine-037",111,1,37,"Heinz 氏小體是一種氧化的血紅素，下列何種溶血性貧血的紅血球內最常見到 Heinz 氏小體？",{"A":15,"B":16,"C":17,"D":18},"免疫性溶血性貧血（immunohemolytic anemia）","地中海型貧血（thalassemia）","鐮刀血球性貧血（sickle cell anemia）","葡萄糖-6-磷酸去氫酶缺乏症（glucose-6-phosphate dehydrogenase deficiency）","D",null,[],"本題考點在於 Heinz 氏小體(氧化變性的血紅素沉積)最常見於哪種溶血性貧血。葡萄糖-6-磷酸去氫酶(G6PD)缺乏症患者無法產生足夠 NADPH 以維持穀胱甘肽還原態,紅血球抗氧化能力不足,遇氧化壓力時血紅素被氧化變性沉積成 Heinz 氏小體,故選 D。A 免疫性溶血性貧血由抗體介導破壞紅血球,特徵為球形紅血球而非 Heinz 小體。B 地中海型貧血是血紅素鏈合成障礙,以標靶紅血球、小球性貧血為主。C 鐮刀血球性貧血因 HbS 聚合使紅血球鐮刀化,特徵為鐮刀狀紅血球。唯 G6PD 缺乏與 Heinz 小體最相關,故正解為 D。","G6PD 是磷酸戊糖路徑首要酵素,產生 NADPH 供穀胱甘肽維持還原態以中和氧化物。缺乏時紅血球對氧化壓力極脆弱,誘因包括蠶豆(蠶豆症)、氧化性藥物(磺胺類、抗瘧藥 primaquine、部分解熱鎮痛藥)、感染、萘丸(樟腦丸)。氧化的血紅素變性沉積為 Heinz 小體,可用特殊染色(如結晶紫)顯現;脾臟巨噬細胞咬除 Heinz 小體形成「咬痕細胞(bite cells)」。此為 X 連鎖遺傳,台灣新生兒常規篩檢項目之一。認得「Heinz 小體=氧化壓力=G6PD」這條線即可判題。",[25,27,29,31],{"term":26,"count":11},"Heinz 氏小體",{"term":28,"count":11},"G6PD 缺乏症",{"term":30,"count":11},"氧化壓力溶血",{"term":32,"count":11},"NADPH 與穀胱甘肽",[34,38,43,48,54,59],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-111-1-basic-medicine-038","下列何種肝炎病毒，只能在 B 型肝炎病毒存在的情況下共同感染？",38,{"webId":39,"stem":40,"number":41,"year":42,"session":11},"nurse-112-1-basic-medicine-004","下列那個脊髓區段負責支配上肢？",4,112,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-112-2-basic-medicine-048","下列病毒感染與其所引起疾病之配對關係，何者錯誤？",48,2,{"webId":49,"stem":50,"number":51,"year":52,"session":53},"nurse-113-3-basic-medicine-046","肝炎病毒中，那一種病毒需要 B 型肝炎病毒同時感染，才能幫助它複製繁殖？",46,113,3,{"webId":55,"stem":56,"number":57,"year":58,"session":11},"nurse-115-1-basic-medicine-050","下列何種症狀最常見於鉤蟲（hookworms）成蟲感染？",50,115,{"webId":60,"stem":61,"number":62,"year":63,"session":47},"nurse-106-2-basic-medicine-064","免疫抑制劑 sirolimus（又稱 rapamune）可緩解免疫組織損壞。此藥物在淋巴細胞作用之敘述，何者正確？",64,106,"2026-09-04",1788510733007]