目的探讨手足口病重症病例的病原学和流行病学特征,为重症病例的防治提供实验室依据。方法采用荧光RT-PCR法对手足口病患者咽拭子标本进行肠道病毒通用型、肠道病毒71型(EV71)、柯萨奇病毒A组16型(CoxA16)核酸检测,用SPSS 11.5软件进行统计学分析。结果重症病例肠道病毒阳性检出率和EV71病原构成比显著高于普通病例,其中并发肺水肿的重症病例,EV71阳性检出率最高,为54.84%。在实验室确诊病例中,重症病例构成比在男女性别上无差异,而EV71阳性病例构成比男孩低于女孩。年龄越小,重症病例越易发生,EV71阳性病例构成比在年龄上无差异。重症确诊病例发病高峰出现在5—7月,但重症确诊病例和EV71阳性病例在确诊病例中的构成比高峰则出现在8、9月。重症确诊病例多集中于南部和中部,而EV71阳性病例在确诊病例中的构成比以北部最高,为56.61%。结论 EV71为重症病例的主要病原体,但重症确诊病例和EV71阳性病例在流行病学分布特征上有差异,加强低年龄组儿童在5—9月的防控,可有效降低手足口病重症病例的发生。 Objective To explore the etiological and epidemiological characteristics of severe cases of hand-foot-mouth disease and provide laboratory evidence for the prevention and treatment of severe cases. Methods The pharyngeal swab samples from HFMD patients were detected by RT-PCR with EV71 and CoxA16, and SPSS11.5 software Statistical analysis. Results The positive rate of enterovirus in severe cases was significantly higher than that in EV71. The severe cases with pulmonary edema had the highest positive rate of EV71 (54.84%). In laboratory-confirmed cases, there was no difference in the incidence of severe cases between men and women, whereas EV71-positive cases constituted less than boys in boys. The younger, the more likely to occur in severe cases, EV71-positive cases were no difference in age. Severe confirmed cases peaked in May-July, but the diagnosis of severe cases and EV71-positive cases in the diagnosis of the composition of the peak than the peak appeared in August and September. Severe confirmed cases and more concentrated in the southern and central, and the EV71-positive cases in the diagnosis of the highest proportion of cases to the north, was 56.61%. Conclusions EV71 is the major pathogen of severe cases, but the epidemiological characteristics of severe cases and EV71-positive cases are different, and the prevention and control of children in the lower age group from May to September can be effectively reduced, which can effectively reduce the incidence of HFMD occur.