# 一名克隆氏症個案預定開始使用英夫利昔單抗。第一次輸注前必須完成哪一項檢查？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391818&lang=zh-tw  
> language: zh-TW  
> subject: Crisis Intervention  
> category: PSI

## 題目

一名克隆氏症個案預定開始使用英夫利昔單抗。第一次輸注前必須完成哪一項檢查？

## 選項

1. 進行潛伏結核篩檢（TST 或 IGRA）加上 HBV 血清學，因為 TNF-alpha 抑制劑可能使潛伏結核與 B 肝再活化 **✔ 正確答案**
2. 心臟超音波
3. 骨密度檢查
4. 胸部CT

**正確答案: 1**

## 解析

正確（2）：抗TNF生物製劑（英夫利昔單抗、adalimumab、etanercept、certolizumab、golimumab）有嚴重感染警示，包括潛伏結核再活化與B型肝炎。第一劑前應做TST/IGRA與HBV血清學；潛伏結核需先治療。（1、3、4）不是標準生物製劑前評估。

## 深入解析

記憶提示 抗TNF開始前先想TB與B肝；輸注時也要監測輸注反應。

## 臨床情境

情境 35歲男性難治型克隆氏症，預定使用英夫利昔單抗 5 mg/kg IV。輸注前檢核。

## 重要概念

- **TNF-alpha 抑制劑** — 生物製劑類別，包含英夫利昔單抗、adalimumab、etanercept；有感染相關警示。
- **潛伏結核篩檢** — 開始抗TNF治療前以TST或IGRA檢查。
- **英夫利昔單抗輸注反應** — 可為輸注中/24小時內急性反應，或1-14天延遲反應；必要時用前置用藥並調整輸注速度。

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