目的了解2010年发生的重症手足口病(HFMD)病原及流行特征,为济南地区重症HFMD的防控提供科学依据。方法对辖区哨点医院送检的40例重症手足口病病例样本,应用RT-PCR技术检测肠道病毒71型(EV71)、柯萨奇病毒A组16型(CoxA16)、非EV71和CoxA16的其他肠道病毒(EV);选取10例阳性病例样本进行VP1基因的扩增和核苷酸序列测定。结果 40例重症手足口病病例中,有38例感染了肠道病毒,其中感染EV71的有30例,占78.95%;感染CoxA16的有3例,占7.89%;感染其他肠道病毒的5例,占13.16%。手足口病重症病例呈散发,主要集中于5～8月份,病例人群男性高于女性(3.44∶1),其中2岁以下幼儿是重症病例发生主要年龄段,占77.50%;10株EV71阳性扩增产物经基因测序,证实均为C4b基因亚型。结论 EV71是引起2010年济南地区手足口病重症及死亡病例的主要病毒类型,且主要为C4b基因亚型。 Objective To understand the pathogens and epidemiological features of severe hand-foot-mouth disease (HFMD) in 2010 and provide a scientific basis for the prevention and control of severe HFMD in Jinan. Methods Forty cases of severe HFMD in sentinel hospitals were detected by reverse transcription polymerase chain reaction (RT-PCR), including EV71, CoxA16, non-EV71 and CoxA16 Other enterovirus (EV); 10 cases of positive cases selected VP1 gene amplification and nucleotide sequence determination. Results Of the 40 cases of severe HFMD, 38 cases were infected with enterovirus, of which 30 cases were infected with EV71, accounting for 78.95%; 3 cases were infected with CoxA16, accounting for 7.89%; 5 cases were infected with other enteroviruses , Accounting for 13.16%. Hand-foot-mouth disease was exacerbated, mainly in May-August. The case population was higher than that of females (3.44:1), of which children under 2 years old were the major age groups with severe cases accounting for 77.50% By gene sequencing, the product was confirmed to be C4b gene subtypes. Conclusion EV71 is the major virus type that causes severe cases and deaths of hand-foot-mouth disease in Jinan area in 2010, and is mainly subtypes of C4b gene.