[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-111-1-basic-medicine-058":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":27},"nurse-111-1-基礎醫學-058","nurse-111-1-basic-medicine-058",111,1,58,"血管緊縮素轉換酶抑制劑用於治療充血性心衰竭病人，其作用機轉為何？",{"A":15,"B":16,"C":17,"D":18},"增加血中腎素活性，但不影響心臟纖維化","減少腎素產生，進而減少心臟纖維化","減少周邊血管阻抗，促進利尿來降低心臟後負荷","減少醛固酮（aldosterone）分泌，可降低心臟前負荷","D",null,[],"本題考點為血管收縮素轉換酶抑制劑（ACEI）治療充血性心衰竭的機轉。ACEI 抑制 ACE，使血管收縮素 II（angiotensin II）生成減少，進而減少醛固酮（aldosterone）分泌；醛固酮下降會減少鈉水滯留、降低循環血量與心臟前負荷，故 D 敘述正確，選 D。A 說法方向與治療目的不符。B 的『減少腎素產生』並非 ACEI 直接機轉，ACEI 反因負回饋反而使腎素活性上升。C 提到減少周邊阻抗確有其事（angiotensin II 減少使血管舒張、降後負荷），但本題正解鎖定醛固酮下降降前負荷的敘述。故選 D。","RAAS 機轉：腎素→angiotensin I→（ACE）→angiotensin II（強力血管收縮＋促醛固酮）。ACEI 阻斷此步：血管舒張降後負荷、醛固酮下降降前負荷（利鈉排水），並抑制 angiotensin II 促心肌與血管纖維化與重塑，改善心衰竭預後。ACE 亦分解緩激肽（bradykinin），受抑後 bradykinin 累積可致乾咳與血管性水腫。負回饋使 ACEI 使用時血漿腎素活性上升，故 B 錯。記憶：『ACEI＝降前後負荷＋抗重塑』。",[25,28,30,32],{"term":26,"count":27},"ACE 抑制劑",5,{"term":29,"count":27},"RAAS 系統",{"term":31,"count":11},"醛固酮下降降前負荷",{"term":33,"count":11},"周邊阻抗下降降後負荷",[35,39,44,49,54,60],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-111-1-basic-medicine-059","下列抗高血壓治療藥物，何者不會產生心搏過速之副作用？",59,{"webId":40,"stem":41,"number":42,"year":43,"session":11},"nurse-112-1-basic-medicine-025","一位患有慢性胃食道逆流的病人，在食道下三分之一處發現有區域性柱狀上皮的出現，此現象稱為：",25,112,{"webId":45,"stem":46,"number":47,"year":43,"session":48},"nurse-112-3-basic-medicine-019","下列何者屬於腸道神經系統（enteric nervous system）？",19,3,{"webId":50,"stem":51,"number":52,"year":53,"session":11},"nurse-114-1-basic-medicine-017","下列何者為負責分泌胃酸的細胞？",17,114,{"webId":55,"stem":56,"number":57,"year":58,"session":59},"nurse-115-2-basic-medicine-021","一名 20 歲男性，由於車禍導致腿部骨折，以石膏固定傷肢。在骨折癒合期間，肌肉量會減少。這是下列何種類型的細胞適應性反應？",21,115,2,{"webId":61,"stem":62,"number":27,"year":63,"session":11},"nurse-107-1-basic-medicine-005","腹骨盆腔九分區的假想線中，最下方的水平線通過下列何者？",107,"2026-09-04",1788510733198]