阿摩線上測驗
28 關於慢性腎臟病（chronic kidney disease）的敘述，下列何者最不正確？
(A)根據目前國際所認知的分期，一位 70 歲 72 公斤的男性病人，他的血清肌酸酐為 2.5 mg/dL，應該
是第四期
(B)使用 captopril 可以延緩慢性腎病衰竭的速度，主要是可以增加腎絲球內壓力，提高腎絲球過濾速率
(C)目前最被研究和腎臟衰竭相關的基因是 angiotensin-converting enzyme。具有 deletion（D）的同質
接合者（DD），其腎功能比較會進展至衰竭
(D)有蛋白尿的慢性腎臟病人，血壓的控制目標是在 125/75 mmHg
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統計： A(4), B(32), C(1), D(3), E(0) #1061383
統計： A(4), B(32), C(1), D(3), E(0) #1061383
詳解 (共 2 筆)
Chris
#3904903
Studies have shown that different genotypes of angiotensin converting enzyme can lead to varying influence on athletic performance. ACE I/D polymorphism consists of either an insertion (I) or absence (D) of a 287 base pair alanine sequence in intron 16 of the gene.[23] People carrying the I-allele usually have lower ACE levels while people carrying the D-allele have higher ACE levels.
People carrying the D-allele are associated with higher ACE levels that cause higher levels of angiotensin II. During physical exercise the blood pressure of D-allele carriers will therefore increase sooner than for I-allele carriers. This results in a lower maximal heart rate and lower maximum oxygen uptake (VO2max). Therefore, D-allele carriers have a 10% increased risk of cardiovascular diseases. Furthermore, the D-allele is associated with a greater increase in left ventricular growth in response to training compared to the I-allele.[24] On the other hand, I-allele carriers usually show an increased maximal heart rate due to lower ACE levels, higher maximum oxygen uptake and therefore show an enhanced endurance performance.[24]
The I allele is found with increased frequency in elite distance runners, rowers and cyclists. Short distance swimmers show a higher occurrence of D-allele carriers in their specific discipline, since their discipline relies more on strength than endurance.[25][26]
People carrying the D-allele are associated with higher ACE levels that cause higher levels of angiotensin II. During physical exercise the blood pressure of D-allele carriers will therefore increase sooner than for I-allele carriers. This results in a lower maximal heart rate and lower maximum oxygen uptake (VO2max). Therefore, D-allele carriers have a 10% increased risk of cardiovascular diseases. Furthermore, the D-allele is associated with a greater increase in left ventricular growth in response to training compared to the I-allele.[24] On the other hand, I-allele carriers usually show an increased maximal heart rate due to lower ACE levels, higher maximum oxygen uptake and therefore show an enhanced endurance performance.[24]
The I allele is found with increased frequency in elite distance runners, rowers and cyclists. Short distance swimmers show a higher occurrence of D-allele carriers in their specific discipline, since their discipline relies more on strength than endurance.[25][26]
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Elsie
#6266274
(A) Cockcroft-Gault equation: eGFR= [(140-age)*IBW]/(72*SCr), 若是女性需再*0.85
(B) ACEi 機制: 擴張出球小動脈>入球小動脈=> 降低腎絲球後負荷
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