65株白色念珠菌的分离鉴定及药敏结果分析

目的了解白色念珠菌的分布状况和对9种常用抗真菌药物的敏感性,为临床用药提供参考.方法真菌的分离按照<全国临床检验操作规程>中有关酵母样菌的要求进行,其中白色念珠菌的鉴定和药物敏感试验采用珠海黑马BACT-IST微生物分析系统.结果白色念珠菌在老年病人中分离率高达84.5%,在9种抗真菌药物中,对氟胞嘧啶、两性霉素B、制霉菌素和氟康唑的敏感率均在90%以上;伊曲康唑和克霉唑次之,敏感率分别为82.9%和80.4%;益康唑的作用最差,敏感率仅有56.9%,耐药率高达26.2%.结论白色念珠菌对常用抗真菌药物有不同程度的耐药性,治疗时应选择敏感的药物,防止耐药性扩散.     

146株念珠菌的分布及药敏结果分析

目的对临床送检标本分离出的念珠菌,进行细菌分布及药敏结果分析,为临床用药提供依据. 方法按常规方法转种培养,经涂片染色,发现孢子或菌丝者转种法国科玛嘉显色培养基进行分纯,用法国生物梅里埃公司VITEK-32细菌仪专用YBC卡鉴定,用ATB Fungus进行耐药监测,其中氟康唑用纸片扩散法进行监测. 结果分离出念珠菌 146株,以白色念珠菌最为多见,其次是光滑念珠菌;药敏结果敏感率由高到低为:两性霉素B 87.7%、氟康唑87.7%、5-氟胞嘧啶84.3%、制菌霉素72.6%、益康唑17.8%、咪康唑15.0%、酮康唑14.4%. 结论念珠菌感染中以白色念珠菌最为多见,药敏结果显示氟康唑、氟胞嘧啶、两性霉素B敏感性高;对送检标本及时进行真菌培养和药敏试验,合理使用抗生素和抗真菌药,减少多重耐药和深部真菌感染的发生.     

糖皮质激素引起口腔念珠菌病患者综合化护理的效果分析

目的 观察分析在糖皮质激素引起口腔念珠菌病患者中开展综合化护理干预的临床效果。方法 选择医院2021年2月-2022年12月收治的68例口腔念珠菌病患者为研究对象,根据组间性别、年龄、抗生素平均应用时长等基本资料均衡可比的原则分为对照组（n=34）和观察组（n=34）。对照组采用常规护理干预方式,观察组采用综合化护理干预方式,对两组患者口腔念珠菌转阴的时间、护理的满意度和相关知识知晓程度进行对比分析。结果 综合化护理干预后,观察组患者转阴时间明显低于对照组,差异有统计学意义（P<0.05）;观察组护理满意度为97.06%,高于对照组的79.41%,但差异无统计学意义（P>0.05）;观察组患者对口腔念珠菌病感染病因、表现症状、治疗及预防措施、糖皮质激素不良反应等内容的知晓程度高于对照组,差异有统计学意义（P<0.05）。结论 将综合化护理干预应用到糖皮质激素引起口腔念珠菌病患者中,可明显缩短患者转阴的时间,并显著提升患者对相关知识的知晓程度。     

口腔念珠菌病患者唾液硝酸根分泌能力升高

目的 了解唾液硝酸根和、亚硝酸根在口腔感染防御上的作用.方法 收集33例口腔念珠菌病患者及34名无口腔念珠菌病对照者的唾液,高效液相色谱法测定硝酸根、亚硝酸根含量,对其中10例患者治疗前后的唾液硝酸根、亚硝酸根含量进行比较,结果 分别采用独立样本t检验或配对样本t检验(α=0.05).结果 腮腺液硝酸根的浓度和分泌速度:患者组为(49.70±0.50)ms/L和(27.71±0.50)μ/min,对照组为(21.51±0.60)ms/L和(12.55±0.60)μg/min;混合唾液硝酸根的浓度和分泌速度:患者组为(6.46±0.94)ms/L和(10.57±0.91)μg/min,对照组为(1.11±0.70)mg/L和(2.10±0.74)μg/min;混合唾液亚硝酸根的浓度和分泌速度:患者组为(8.48±0.58)mg/L和(13.91±0.55)μg/min,对照组为(3.39±0.53)mg/L和(6.42±0.58)μg/min.以上检测项目患者组与对照组比较差异均有统计学意义(t值分别为2.692、2.554、3.792、3.464、2.888、2.397.P值均<0.05).念珠菌病患者治愈后,其腮腺液及混合唾液硝酸根、亚硝酸根水平均下降,其中腮腺液硝酸根的分泌速度治疗前后分别为(37.50±0.50)μg/min和(14.34±0.64)μg/min,混合唾液硝酸根的浓度和分泌速度治疗前后分别为(14.29±1.01)mg/L和(2.59±1.03)mg/L、(25.97±0.93)μg/min和(4.12±1.00)μg/min,以上三者治疗前后的改变差异有统计学意义(t值分别为3.142、3.475、3.922,P值均<0.05).结论 口腔念珠菌病患者的唾液硝酸根和亚硝酸根水平均有明显升高,治疗后下降,这种变化可能与机体的防御性反应有关.     

口腔念珠菌病患者唾液硝酸根分泌能力升高

Objective To observe the alterations of saliva nitrate and nitrite level in patients with oral candidiasis. Methods Parotid saliva and whole saliva were collected from 33 patients and 34 healthy volunteers. Concentrations of nitrate and nitrite in saliva were determined by high-performance liquid chromatography. Follow-up observation was performed on 10 patients after treatment. The data were statistically analyzed with independent-samples t test or paired-samples t test at α=0. 05. Results There was significant increase of the concentrations and secretion rate of parotid saliva nitrate in patient group as compared with controls: (49. 70±0. 50) vs (21.51±0. 60) mg/L (t=2. 692,P=0. 009) and (27.71±0. 50) vs (12. 55±0. 60)μg/min (t=2. 554, P=0. 013), respectively. Significantly increased concentrations and secretion rate of nitrate and nitrite [nitrate: (6. 46±0. 94) vs (1.11±0. 70) mg/L (t=3.792,P=0.000); nitrite: (8.48±0.58) vs (3.39±0.53) mg/L (t=2.888,P=0.005); nitrate secretion rate: (10. 57±0. 91) vs (2. 10±0. 74)μg/min (t=3.464, P=0. 001) ; nitrite secretion rate:(13.91±0.55) vs (6.42±0.58)μg,/min (t=2.397,P=0.020)]were revealed in whole saliva of patients group. Significantly decreased nitrate and nitrite levels were also observed in patients after treatment, especially the changes of parotid saliva nitrate secretion rate [(37. 50±0. 50) vs (14. 34±0. 64)μg/min (t=3. 142, P=0. 012)], whole saliva nitrate [(14.29±1.01) vs (2. 59±1.03) mg/L (t=3.475, P=0. 007)]and whole saliva nitrate secretion rate [(25.97±0. 93) vs (4. 12±1.00)μg/min (t=3. 922,P=0. 003)]. Conclusion The present study revealed the significant increase of salivary nitrate and nitrite level in patients with oral candidiasis is considered to be associated with the host defense reaction.     

口腔念珠菌病患者唾液硝酸根分泌能力升高

Objective To observe the alterations of saliva nitrate and nitrite level in patients with oral candidiasis. Methods Parotid saliva and whole saliva were collected from 33 patients and 34 healthy volunteers. Concentrations of nitrate and nitrite in saliva were determined by high-performance liquid chromatography. Follow-up observation was performed on 10 patients after treatment. The data were statistically analyzed with independent-samples t test or paired-samples t test at α=0. 05. Results There was significant increase of the concentrations and secretion rate of parotid saliva nitrate in patient group as compared with controls: (49. 70±0. 50) vs (21.51±0. 60) mg/L (t=2. 692,P=0. 009) and (27.71±0. 50) vs (12. 55±0. 60)μg/min (t=2. 554, P=0. 013), respectively. Significantly increased concentrations and secretion rate of nitrate and nitrite [nitrate: (6. 46±0. 94) vs (1.11±0. 70) mg/L (t=3.792,P=0.000); nitrite: (8.48±0.58) vs (3.39±0.53) mg/L (t=2.888,P=0.005); nitrate secretion rate: (10. 57±0. 91) vs (2. 10±0. 74)μg/min (t=3.464, P=0. 001) ; nitrite secretion rate:(13.91±0.55) vs (6.42±0.58)μg,/min (t=2.397,P=0.020)]were revealed in whole saliva of patients group. Significantly decreased nitrate and nitrite levels were also observed in patients after treatment, especially the changes of parotid saliva nitrate secretion rate [(37. 50±0. 50) vs (14. 34±0. 64)μg/min (t=3. 142, P=0. 012)], whole saliva nitrate [(14.29±1.01) vs (2. 59±1.03) mg/L (t=3.475, P=0. 007)]and whole saliva nitrate secretion rate [(25.97±0. 93) vs (4. 12±1.00)μg/min (t=3. 922,P=0. 003)]. Conclusion The present study revealed the significant increase of salivary nitrate and nitrite level in patients with oral candidiasis is considered to be associated with the host defense reaction.     

口腔念珠菌病患者唾液硝酸根分泌能力升高

Objective To observe the alterations of saliva nitrate and nitrite level in patients with oral candidiasis. Methods Parotid saliva and whole saliva were collected from 33 patients and 34 healthy volunteers. Concentrations of nitrate and nitrite in saliva were determined by high-performance liquid chromatography. Follow-up observation was performed on 10 patients after treatment. The data were statistically analyzed with independent-samples t test or paired-samples t test at α=0. 05. Results There was significant increase of the concentrations and secretion rate of parotid saliva nitrate in patient group as compared with controls: (49. 70±0. 50) vs (21.51±0. 60) mg/L (t=2. 692,P=0. 009) and (27.71±0. 50) vs (12. 55±0. 60)μg/min (t=2. 554, P=0. 013), respectively. Significantly increased concentrations and secretion rate of nitrate and nitrite [nitrate: (6. 46±0. 94) vs (1.11±0. 70) mg/L (t=3.792,P=0.000); nitrite: (8.48±0.58) vs (3.39±0.53) mg/L (t=2.888,P=0.005); nitrate secretion rate: (10. 57±0. 91) vs (2. 10±0. 74)μg/min (t=3.464, P=0. 001) ; nitrite secretion rate:(13.91±0.55) vs (6.42±0.58)μg,/min (t=2.397,P=0.020)]were revealed in whole saliva of patients group. Significantly decreased nitrate and nitrite levels were also observed in patients after treatment, especially the changes of parotid saliva nitrate secretion rate [(37. 50±0. 50) vs (14. 34±0. 64)μg/min (t=3. 142, P=0. 012)], whole saliva nitrate [(14.29±1.01) vs (2. 59±1.03) mg/L (t=3.475, P=0. 007)]and whole saliva nitrate secretion rate [(25.97±0. 93) vs (4. 12±1.00)μg/min (t=3. 922,P=0. 003)]. Conclusion The present study revealed the significant increase of salivary nitrate and nitrite level in patients with oral candidiasis is considered to be associated with the host defense reaction.     

口腔念珠菌病患者唾液硝酸根分泌能力升高

Objective To observe the alterations of saliva nitrate and nitrite level in patients with oral candidiasis. Methods Parotid saliva and whole saliva were collected from 33 patients and 34 healthy volunteers. Concentrations of nitrate and nitrite in saliva were determined by high-performance liquid chromatography. Follow-up observation was performed on 10 patients after treatment. The data were statistically analyzed with independent-samples t test or paired-samples t test at α=0. 05. Results There was significant increase of the concentrations and secretion rate of parotid saliva nitrate in patient group as compared with controls: (49. 70±0. 50) vs (21.51±0. 60) mg/L (t=2. 692,P=0. 009) and (27.71±0. 50) vs (12. 55±0. 60)μg/min (t=2. 554, P=0. 013), respectively. Significantly increased concentrations and secretion rate of nitrate and nitrite [nitrate: (6. 46±0. 94) vs (1.11±0. 70) mg/L (t=3.792,P=0.000); nitrite: (8.48±0.58) vs (3.39±0.53) mg/L (t=2.888,P=0.005); nitrate secretion rate: (10. 57±0. 91) vs (2. 10±0. 74)μg/min (t=3.464, P=0. 001) ; nitrite secretion rate:(13.91±0.55) vs (6.42±0.58)μg,/min (t=2.397,P=0.020)]were revealed in whole saliva of patients group. Significantly decreased nitrate and nitrite levels were also observed in patients after treatment, especially the changes of parotid saliva nitrate secretion rate [(37. 50±0. 50) vs (14. 34±0. 64)μg/min (t=3. 142, P=0. 012)], whole saliva nitrate [(14.29±1.01) vs (2. 59±1.03) mg/L (t=3.475, P=0. 007)]and whole saliva nitrate secretion rate [(25.97±0. 93) vs (4. 12±1.00)μg/min (t=3. 922,P=0. 003)]. Conclusion The present study revealed the significant increase of salivary nitrate and nitrite level in patients with oral candidiasis is considered to be associated with the host defense reaction.     

口腔念珠菌病患者唾液硝酸根分泌能力升高

Objective To observe the alterations of saliva nitrate and nitrite level in patients with oral candidiasis. Methods Parotid saliva and whole saliva were collected from 33 patients and 34 healthy volunteers. Concentrations of nitrate and nitrite in saliva were determined by high-performance liquid chromatography. Follow-up observation was performed on 10 patients after treatment. The data were statistically analyzed with independent-samples t test or paired-samples t test at α=0. 05. Results There was significant increase of the concentrations and secretion rate of parotid saliva nitrate in patient group as compared with controls: (49. 70±0. 50) vs (21.51±0. 60) mg/L (t=2. 692,P=0. 009) and (27.71±0. 50) vs (12. 55±0. 60)μg/min (t=2. 554, P=0. 013), respectively. Significantly increased concentrations and secretion rate of nitrate and nitrite [nitrate: (6. 46±0. 94) vs (1.11±0. 70) mg/L (t=3.792,P=0.000); nitrite: (8.48±0.58) vs (3.39±0.53) mg/L (t=2.888,P=0.005); nitrate secretion rate: (10. 57±0. 91) vs (2. 10±0. 74)μg/min (t=3.464, P=0. 001) ; nitrite secretion rate:(13.91±0.55) vs (6.42±0.58)μg,/min (t=2.397,P=0.020)]were revealed in whole saliva of patients group. Significantly decreased nitrate and nitrite levels were also observed in patients after treatment, especially the changes of parotid saliva nitrate secretion rate [(37. 50±0. 50) vs (14. 34±0. 64)μg/min (t=3. 142, P=0. 012)], whole saliva nitrate [(14.29±1.01) vs (2. 59±1.03) mg/L (t=3.475, P=0. 007)]and whole saliva nitrate secretion rate [(25.97±0. 93) vs (4. 12±1.00)μg/min (t=3. 922,P=0. 003)]. Conclusion The present study revealed the significant increase of salivary nitrate and nitrite level in patients with oral candidiasis is considered to be associated with the host defense reaction.     

口腔念珠菌病患者唾液硝酸根分泌能力升高

Objective To observe the alterations of saliva nitrate and nitrite level in patients with oral candidiasis. Methods Parotid saliva and whole saliva were collected from 33 patients and 34 healthy volunteers. Concentrations of nitrate and nitrite in saliva were determined by high-performance liquid chromatography. Follow-up observation was performed on 10 patients after treatment. The data were statistically analyzed with independent-samples t test or paired-samples t test at α=0. 05. Results There was significant increase of the concentrations and secretion rate of parotid saliva nitrate in patient group as compared with controls: (49. 70±0. 50) vs (21.51±0. 60) mg/L (t=2. 692,P=0. 009) and (27.71±0. 50) vs (12. 55±0. 60)μg/min (t=2. 554, P=0. 013), respectively. Significantly increased concentrations and secretion rate of nitrate and nitrite [nitrate: (6. 46±0. 94) vs (1.11±0. 70) mg/L (t=3.792,P=0.000); nitrite: (8.48±0.58) vs (3.39±0.53) mg/L (t=2.888,P=0.005); nitrate secretion rate: (10. 57±0. 91) vs (2. 10±0. 74)μg/min (t=3.464, P=0. 001) ; nitrite secretion rate:(13.91±0.55) vs (6.42±0.58)μg,/min (t=2.397,P=0.020)]were revealed in whole saliva of patients group. Significantly decreased nitrate and nitrite levels were also observed in patients after treatment, especially the changes of parotid saliva nitrate secretion rate [(37. 50±0. 50) vs (14. 34±0. 64)μg/min (t=3. 142, P=0. 012)], whole saliva nitrate [(14.29±1.01) vs (2. 59±1.03) mg/L (t=3.475, P=0. 007)]and whole saliva nitrate secretion rate [(25.97±0. 93) vs (4. 12±1.00)μg/min (t=3. 922,P=0. 003)]. Conclusion The present study revealed the significant increase of salivary nitrate and nitrite level in patients with oral candidiasis is considered to be associated with the host defense reaction.     

2012-2013年绵阳市肺结核患者耐药性结果分析

摘要:目的　了解绵阳市肺结核病耐药现状,为制定我市结核病控制策略提供依据。方法　收集2012-2013年绵阳市各县级结核病防治机构推送的经绵阳市疾控中心进行IHN、RFP、EMB、SM、OFX、KM药物敏感性试验已出具实验报告的364例患者资料,采用SPSS17.0进行统计学分析。结果　受试者对6种传统抗结核药（H、R、O、S、E、K）总耐药率为26.10%,耐药率由高到低依次为19.78%、16.76%、9.62%、7.14%、5.49%、2.47%;耐任意一线药率为23.35%,初治患者耐任意一线药率为18.24%,复治患者耐任意一线药率为50.88%;单耐药率7.69%;多耐药率3.85%;耐多药率14.56%;广泛耐药率0.82%;耐药种数以3种及以下居多,占85.26%;未发现耐E、耐K单独耐药病例。结论　加强对耐药结核病的防治是绵阳市目前结核病防控工作的重点,尤其是对复治患者。     

念珠菌性阴道炎菌种分布及耐药性

目的了解本地区妇女泌尿生殖道念珠菌感染情况及对常用药物的耐药性。方法收集我院普妇科、阴道炎科、阴道感染科的781例女性泌尿生殖道标本进行细菌及真菌培养,并就真菌阳性的标本进行药敏实验。结果 781例标本中,共检出念珠菌阳性120例,阳性率15.4%;耐药率由高到低依次为:伊曲康唑(16.7%)、氟康唑(12.5%)、咪康唑(5.8%)、5-氟胞嘧啶(3.3%)、酮康唑(2.5%)、两性霉素B(0)。结论妇科念珠菌感染以白色念珠菌为主,但非白色念珠菌感染比例有所上升。进行菌种鉴定和药敏实验有利于指导临床合理用药。     

口腔真菌感染患者口内假丝酵母菌属分布及药敏性分析

目的了解口腔真菌感染患者口内假丝酵母菌属分布及药敏性,为临床治疗口腔真菌感染提供参考。方法选取2012年2月-2013年4月呼吸内科收治的82例口腔真菌感染患者,采集所有患者口腔黏膜标本,鉴定标本中的假丝酵母菌属菌种,并检测假丝酵母菌属对氟胞嘧啶、两性霉素B、氟康唑、伊曲康唑和伏立康唑的药敏性。结果 82例患者送检标本中共培养出假丝酵母菌属103株,其中白色假丝酵母菌52株、热带假丝酵母菌21株、光滑假丝酵母菌13株,分别占50.5%、20.4%、12.6%;白色假丝酵母菌、热带假丝酵母菌和光滑假丝酵母菌对伏立康唑、两性霉素B的敏感率均为100.0%,其对氟胞嘧啶、氟康唑和伊曲康唑的敏感率分别为80.8%、94.2%、96.2%,85.7%、95.2%、100.0%和76.9%、100.0%、92.3%。结论口腔真菌感染可由多种菌株引起,因此临床中应明确假丝酵母菌属的菌种,并进行药敏试验,有利于选择有效的抗真菌药物,提高疗效。     

口腔感染的病原菌及耐药性分析

目的了解口腔感染的病原菌分布及其对常用抗菌药物的耐药性,以便于指导临床用药。方法对医院2008-2011年收治的230例口腔感染患者的分泌物进行病原菌培养及药敏结果进行分析。结果 230例口腔感染患者检出细菌522株,其中厌氧菌344株,占65.9%,需氧菌178株,占34.1%;在厌氧菌中,主要检出的黑色素普氏菌127株,中间普氏菌88株,口腔链球菌34株,牙龈卟啉单胞菌29株,二氧化碳嗜纤维菌22株,核梭杆菌16株,韦荣球菌14株,共生放线杆菌9株,福赛类杆菌5株;药敏试验表明,厌氧菌株对万古霉素、四环素、头孢曲松高度敏感,敏感率均>90.0%。结论口腔感染患者病原体以厌氧菌为主,可选用万古霉素、四环素、头孢曲松等抗菌药物进行治疗。     

口腔感染的病原菌分布及药敏情况调查分析

目的分析口腔感染患者病原菌分布及药敏情况,为临床合理用药提供参考。方法选取口腔感染患者86例作为研究对象,收集口腔分泌物进行病原菌培养,并行药敏实验。结果本组86例患者中,≤15岁、≥56岁口腔感染患者比例较高,分别占30.2%、40.7%。共检出病原菌351株,其中厌氧菌236株,占67.2%,其在厌氧菌中黑色素普氏菌比例最高(50.4%),其次为口腔链球菌(16.5%);需氧菌115株,占32.8%。对苯唑西林、头孢唑肟、庆大霉素、环丙沙星的耐药较高,分别为49.2%、46.6%、42.0%、40.2%;对万古霉素、四环素、头孢曲松的敏感性较高,分别为98.3%、95.8%、93.6%。结论厌氧菌是口腔感染较为常见的菌种,可选用万古霉素、四环素、头孢曲松等敏感性高的药物治疗。     

骨科患者术后院内感染病原菌及耐药性分析

摘要:目的　探讨研究骨科患者手术后院内感染致病菌的分离情况、菌株的药敏试验结果,为指导临床治疗提供基础资料。方法　对某院收治的120例骨科患者手术后院内感染的标本进行细菌学培养,并对分离出的菌株进行药物敏感试验。结果　120例骨科患者手术后出现院内感染者中,共培养出细菌104株,真菌4株,病原菌总体分离率为90.00%。其中革兰阴性菌为70株,占64.81%,以铜绿假单胞菌和肺炎克雷伯菌为主;革兰阳性菌为34株,以金黄色葡萄球菌和粪肠球菌为主。药敏试验结果显示,大多数革兰阴性菌对β-内酰胺类抗生素、四环素和复方新诺明耐药,对氨基糖苷类和喹诺酮类等抗生素敏感;而绝大多数革兰阳性菌则对β-内酰胺类和碳氢霉稀类抗生素耐药,对万古霉素等敏感。多重耐药菌株则较少出现。结论　骨科患者手术后出现院内感染病原菌以革兰阴性菌为主要病原体,并且分离出的菌株抗生素敏感性各有不同,在具体临床救治过程中应根据实际情况酌情选择抗生素进行合理治疗。     

4种菌落形态铜绿假单胞菌药物敏感性比较

摘要:目的　比较4种菌落形态铜绿假单胞菌的药物敏感性。方法　采用VITEK2 compact全自动细菌鉴定系统及配套的GN、GN16和E-test、K-B纸片等方法对菌株进行鉴定和药物敏感性试验,并用χ2检验进行统计分析。结果　1188株铜绿假单胞菌对亚胺培南和哌拉西林/他唑巴坦敏感率均大于80%;对阿米卡星敏感率为78.3%;对头孢他啶、头孢吡肟、妥布霉素、庆大霉素和左氧氟沙星敏感率均在53.2%～64.9%;对氨曲南敏感率仅为47.2%。黏液型铜绿假单胞菌对常见抗菌药物敏感性均高于典型菌落组,侏儒型铜绿假单胞菌除头孢他啶、头孢吡肟和阿米卡星外,药物敏感性均低于典型菌落组,而大肠菌样型铜绿假单胞菌除了亚胺培南敏感率较低外,其余药物敏感率与典型菌落组相差不大。结论　不同菌落型铜绿假单胞菌药物敏感性不同,希望临床医生在治疗铜绿假单胞菌感染的过程中,尽量根据实验室结果选用合适的抗菌药物,避免诱导铜绿假单胞菌产生对抗菌药物的广泛耐药。     

Haemostasis profile in smoking and nonsmoking women taking low-dose oral contraceptives

The effects of oral contraceptives on coagulation in 258 nonsmoking and in 190 smoking women were determined. In smokers and in nonsmokers taking oral contraceptives, fibrinogen and fibrino-peptide A concentrations were higher than in oral contraceptive nonusers. In nonsmokers, oral contraceptives increased antithrombin II activity. The effects on coagulation of oral contraceptives with a different ethinylestradiol content (from 35 mcg to 20 mcg) were then evaluated in 333 of these women. The biggest changes in coagulation were observed in smokers taking the preparation with the highest estrogen content. Reduction of the ethinylestradiol dose caused a decrease of the changes in coagulation induced by oral contraceptives both in smokers and nonsmokers. These results might suggest that during oral contraception the coagulation system is affected mainly in smokers and that the decrease of the estrogen dose might lower the effects of the association of smoking and oral contraception on coagulation.