57.下列藥物中,何者可增加血液循環中血小板的數量,最適合用於治療慢性免疫性血小板低下症 (chronic immune thrombocytopenia)?
(A)plerixafor
(B)pteroylglutamic acid
(C)romiplostim
(D)hydroxocobalamin

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統計: A(77), B(34), C(322), D(47), E(0) #3378138

詳解 (共 3 筆)

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Katzung《Basic & Clinical Pharmacology, 14th ed.》:

Romiplostim is a thrombopoietin receptor agonist that stimulates megakaryocyte proliferation and differentiation, thereby increasing platelet production. It is approved for the treatment of chronic immune thrombocytopenia (ITP) in patients with inadequate response to corticosteroids, immunoglobulins, or splenectomy.

選項解析

A. plerixafor ❌

CXCR4 antagonist

作用:

  • 動員 hematopoietic stem cells 自骨髓進入周邊血液
  • 配合 G-CSF 收集幹細胞

用途:

  • 自體造血幹細胞移植

不是增加血小板。

B. pteroylglutamic acid ❌

就是 Folic acid(Vitamin B9)

用途:

  • 巨球性貧血
  • 懷孕補充葉酸
  • Folate deficiency

不能治療 ITP。

C. romiplostim ✅

Thrombopoietin (TPO) receptor agonist

作用:

  • 活化 c-Mpl(TPO receptor)
  • 刺激 megakaryocyte
  • 增加 platelet production

適應症:

  • Chronic immune thrombocytopenia (ITP)

為本題正確答案。

D. hydroxocobalamin ❌

Vitamin B12

用途:

  • 惡性貧血(pernicious anemia)
  • Vitamin B12 deficiency
  • Cyanide poisoning 解毒

與 ITP 無關。

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