[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-008":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"lastmod":63},"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-115-1-基礎醫學-008","nurse-115-1-basic-medicine-008",115,1,8,"下列何種激素最可能造成孕婦發生妊娠糖尿病？",{"A":15,"B":16,"C":17,"D":18},"人類絨毛膜促性腺激素","人類胎盤泌乳素","黃體素","催產素","B",null,[],"本題考點在於妊娠期胰島素抗性的主要來源。依胎盤的內分泌功能,人類胎盤泌乳素具明顯的抗胰島素作用,促進脂肪分解使游離脂肪酸上升,並降低母體周邊組織對胰島素的敏感度,以保留葡萄糖優先供胎兒使用;其分泌量隨胎盤增大而在妊娠中後期攀升,與妊娠糖尿病的發生時序相符,故選 B。A 人類絨毛膜促性腺激素主要維持黃體以延續黃體素分泌並用於驗孕。C 黃體素雖也略增胰島素抗性,但強度不及胎盤泌乳素。D 催產素作用於子宮收縮與乳汁射出,與醣類代謝無關。","妊娠糖尿病的病生理是「抗胰島素荷爾蒙上升,母體胰島 B 細胞代償不足」。抗胰島素陣容包含人類胎盤泌乳素、雌激素、黃體素、皮質醇與胎盤生長激素,其中胎盤泌乳素分量最重且與胎盤重量成正比,這解釋兩件事:一是篩檢時機定在妊娠 24 到 28 週(抗性剛好明顯化),二是胎盤娩出後胰島素需求急降。胎盤泌乳素的結構與生長激素、泌乳素同源,故兼具促生長與促乳腺發育作用,並動員母體脂肪作為能量以節省葡萄糖。延伸可連結妊娠糖尿病對胎兒的影響(巨嬰、出生後低血糖)、口服葡萄糖耐量試驗判讀,以及產後追蹤第二型糖尿病風險。",[25,28,29,31,32],{"term":26,"count":27},"胰島素抗性",2,{"term":16,"count":11},{"term":30,"count":11},"妊娠糖尿病",{"term":15,"count":11},{"term":33,"count":11},"胎盤內分泌功能",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-115-1-basic-medicine-009","利尿劑主要作用機制為下列何者？",9,{"webId":40,"stem":41,"number":42,"year":43,"session":11},"nurse-106-1-basic-medicine-005","下列何者是維持背部直立最重要的肌肉？",5,106,{"webId":45,"stem":46,"number":47,"year":43,"session":27},"nurse-106-2-basic-medicine-019","下列何種細胞特性為骨骼肌特有，心肌與平滑肌則無？",19,{"webId":49,"stem":50,"number":51,"year":52,"session":27},"nurse-107-2-basic-medicine-057","下列抗血小板凝集藥物中，何者之作用機制為抑制磷酸雙酯酶（phosphodiesterase）？",57,107,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-109-1-basic-medicine-021","出生後，骨骼肌（skeletal muscle）受損傷或死亡，下列那一種細胞可進行修補？",21,109,{"webId":59,"stem":60,"number":61,"year":62,"session":11},"nurse-110-1-basic-medicine-055","下列何者不是 physostigmine 的作用？",55,110,"2026-08-06",1787299087539]