[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-021":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"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":11},"nurse-115-1-基礎醫學-021","nurse-115-1-basic-medicine-021",115,1,21,"有關血管受傷後的止血作用之敘述，下列何者錯誤？",{"A":15,"B":16,"C":17,"D":18},"內皮素（endothelin）的釋放可導致血管收縮","血小板與血管內皮細胞上的選擇素（E-selectin）結合，形成初級止血栓","組織因子（tissue factor）可活化凝血機制","凝血酵素調節素（thrombomodulin）可阻斷凝血機制","B",null,[],"本題考點在於初級止血與凝血調控的分子機制。依血小板黏附的機轉,血管受傷後血小板是透過表面 GPIb 受體與內皮下暴露的 von Willebrand 因子及膠原蛋白結合而黏附、活化、聚集,選擇素 E-selectin 的角色是內皮細胞捕捉白血球滾動附著以進入發炎組織,與初級止血栓的形成無關,故 B 敘述錯誤。A 正確,受損內皮釋放內皮素造成血管收縮以減少出血。C 正確,組織因子與第七因子結合啟動外在凝血途徑。D 正確,凝血酵素調節素結合凝血酶後活化蛋白 C,屬抗凝機制。","止血分三步:血管收縮(內皮素與神經反射)、初級止血栓(血小板黏附聚集,由 vWF 與 GPIb、GPIIb\u002FIIIa 與纖維蛋白原介導)、次級止血栓(凝血瀑布生成纖維蛋白把血栓固定)。內皮細胞是雙面角色:完整時抗凝(分泌前列環素、一氧化氮、凝血酵素調節素、抗凝血酶輔因子),受損暴露內皮下組織時促凝(組織因子、vWF、膠原蛋白)。凝血酵素調節素的巧妙處在於把凝血酶從促凝改為抗凝——凝血酶結合它之後轉去活化蛋白 C,再滅活第五 a 與第八 a 因子,形成自我煞車。延伸概念:von Willebrand 病與血小板功能異常的出血型態(皮膚黏膜點狀出血)對比凝血因子缺乏(深部組織與關節出血)。",[25,27,29,31,33],{"term":26,"count":11},"血小板黏附與 GPIb",{"term":28,"count":11},"von Willebrand 因子",{"term":30,"count":11},"E-selectin 與白血球附著",{"term":32,"count":11},"組織因子與外在途徑",{"term":34,"count":11},"凝血酵素調節素與蛋白 C",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-115-1-basic-medicine-022","關於慢性肉芽腫病（chronic granulomatous disease）的敘述，下列何者正確？",22,{"webId":41,"stem":42,"number":43,"year":44,"session":11},"nurse-106-1-basic-medicine-018","有關腦部代謝之敘述，下列何者正確？",18,106,{"webId":46,"stem":47,"number":48,"year":44,"session":49},"nurse-106-2-basic-medicine-032","小腸上具備有免疫功能的細胞位在何處？",32,2,{"webId":51,"stem":52,"number":53,"year":54,"session":49},"nurse-107-2-basic-medicine-070","臘腸桿菌毒素（Botulinum toxin）可以用於美容除皺之機制為何？",70,107,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-109-1-basic-medicine-034","有關嬰兒多囊性腎病變之敘述，下列何者正確？",34,109,{"webId":61,"stem":62,"number":63,"year":64,"session":11},"nurse-110-1-basic-medicine-068","下列何者目前沒有疫苗可以預防？",68,110,"2026-08-06",1787299087676]