目的分析重症手足口病的病原体,为预防和控制重症手足口病提供依据。方法采集我院PICU收治的79例重症手足口病患儿的粪便、肛拭子、咽拭子、疱疹液等标本进行RT-PCR定性检测肠道病毒通用引物及EV71和CA16的VP1基因的特异性引物进行RT-PCR鉴定。结果共收集标本257份,肠道病毒通用引物阳性164例,EV71阳性118例,CoA16阳性40例,其他6例。其中粪便标本79份,病毒分离阳性61份,阳性率为77.2%;肛拭子79份,病毒分离阳性53份,阳性率为67.1%;咽拭子79份,病毒分离阳性41份,阳性率为51.9%;疱疹液20份,病毒分离阳性9份,阳性率为45%。结论 EV71是引起重症手足口病的主要病原体。粪便、肛拭子、咽拭子、疱疹液的阳性率不同,以粪便阳性率最高。 Objective To analyze the pathogens of severe hand-foot-mouth disease and provide basis for prevention and control of severe hand-foot-mouth disease. Methods The specimens of stool, anal swab, throat swab and herpes fluid of 79 severe hand-foot-mouth disease patients were collected by PICU in our hospital for qualitative detection by RT-PCR of the universal primers of enterovirus and the VP1 gene of EV71 and CA16 The primers were identified by RT-PCR. Results Totally 257 samples were collected, 164 were positive for enterovirus, 118 were EV71 positive, 40 were CoA16 positive and 6 were other. Among them, 79 were stool specimens, 61 were positive for virus isolation, the positive rate was 77.2%; 79 were anal swabs, 53 were positive for virus isolation, the positive rate was 67.1%; throat swabs were 79, 41 were positive for virus isolation, the positive rate 51.9%; herpes fluid 20, 9 positive virus isolation, the positive rate of 45%. Conclusion EV71 is the major causative agent of HFMD. Feces, anal swab, throat swab, herpes fluid positive rate is different, the highest positive rate of stool.