[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-113-3-basic-medicine-035":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"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":27},"nurse-113-3-基礎醫學-035","nurse-113-3-basic-medicine-035",113,3,35,"下列藥物中，何者可減少 angiotensin II 生成，並且使體內 bradykinin 含量增加，因此產生血管舒張作用而降低血壓？",{"A":15,"B":16,"C":17,"D":18},"lisinopril","amlodipine","methyldopa","losartan","A",null,[],"本題考點在於降血壓藥物作用於腎素—血管收縮素系統的機轉差異。lisinopril 屬血管收縮素轉換酶抑制劑(ACE inhibitor),抑制 ACE 使 angiotensin I 無法轉為 angiotensin II,同時因 ACE 亦負責分解緩激肽(bradykinin),酶被抑制後 bradykinin 累積、促血管舒張而降壓,符合題幹描述,故選 A。B amlodipine 為鈣離子通道阻斷劑,舒張血管但不影響 angiotensin 或 bradykinin。C methyldopa 為中樞性 α2 促效劑,降低交感輸出,機轉不同。D losartan 為血管收縮素受體阻斷劑(ARB),阻斷 AT1 受體卻不影響 bradykinin 代謝,故不使 bradykinin 增加。","ACEI 與 ARB 的關鍵區別在於 bradykinin:ACE(即 kininase II)同時負責生成 angiotensin II 與分解 bradykinin,故 ACEI 使 bradykinin 累積,這解釋了 ACEI 特有的乾咳與血管性水腫副作用;ARB 只擋 AT1 受體、不動 bradykinin,較少乾咳。兩者皆降低 angiotensin II 的血管收縮與醛固酮分泌效應,具腎臟保護作用(降低腎絲球內壓),常用於糖尿病腎病與心衰。命名記憶:「-pril」結尾為 ACEI(如 lisinopril、captopril、enalapril),「-sartan」結尾為 ARB(如 losartan、valsartan)。禁忌:懷孕、雙側腎動脈狹窄、高血鉀。",[25,28,30,32],{"term":26,"count":27},"ACE 抑制劑",5,{"term":15,"count":29},1,{"term":31,"count":29},"bradykinin 累積與乾咳",{"term":33,"count":29},"與 ARB(losartan)機轉區別",[35,39,45,50,55,60],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-113-3-basic-medicine-036","下列藥物中，何者為抗凝血劑（anticoagulant），主要用於預防深層靜脈栓塞（deep vein thrombosis）生成？",36,{"webId":40,"stem":41,"number":42,"year":43,"session":44},"nurse-114-2-basic-medicine-032","下列何者不屬於毒蕈鹼拮抗劑（muscarinic antagonist）的臨床適應症？",32,114,2,{"webId":46,"stem":47,"number":48,"year":49,"session":29},"nurse-115-1-basic-medicine-026","下列何種疾病會出現 Barts 氏血紅素（Hb Barts）？",26,115,{"webId":51,"stem":52,"number":53,"year":54,"session":44},"nurse-106-2-basic-medicine-044","卵巢甲狀腺腫（struma ovarii）是屬於一種：",44,106,{"webId":56,"stem":57,"number":58,"year":59,"session":29},"nurse-108-1-basic-medicine-008","下列何者的靜脈血，不經由肝門靜脈進入肝臟？",8,108,{"webId":61,"stem":62,"number":63,"year":64,"session":29},"nurse-109-1-basic-medicine-042","若家族中有第二型糖尿病的病史，罹患糖尿病的機會也將比較高。第二型糖尿病的遺傳模式屬於：",42,109,"2026-09-04",1788510751788]