目的探讨合并颅内感染的手足口病的临床及病原学特点,为该病的早期诊治提供依据。方法回顾性分析43例手足口病合并颅内感染患儿(颅内感染组)及同期住院的45例未合并颅内感染的手足口病患儿(对照组)的临床资料。结果手足口病伴发颅内感染占同期手足口病患病人数的1.36%,5月至8月为发病高峰期,与对照组相比,颅内感染患儿发热时间延长(P<0.01),出现典型皮疹的比例下降(P<0.05),外周血白细胞计数上升(P<0.05),动脉收缩压及空腹血糖值升高(P<0.01),年龄和性别两组差异均无统计学意义(均P>0.05)。颅内感染病例中,脑干脑炎占51.16%(22/43)。脑干脑炎患儿5岁以下者占95.45%(21/22),与其他年龄患儿相比,差异有统计学意义(P<0.05)。颅内感染患儿脑脊液检查存在脑脊液压力及细胞数的异常。病原学检查方面,明确为EV71感染者29例(占67.44%),明确为柯萨奇病毒A16感染者5例(占11.63%),有9例未明确相关病原体。EV71感染率在脑干脑炎患儿及其他类型颅内感染患儿之间差异无统计学意义(P>0.05)。结论手足口病患儿如出现高热不退、血压升高、外周血白细胞计数上升、血糖升高等情况,须警惕合并颅内感染,尤其须重视皮疹不典型的患儿。EV71是本院收治手足口病合并颅内感染患儿的主要病原体。5岁以下的小年龄组患儿易合并脑干脑炎。脑脊液细胞学检查大多数符合病毒性中枢神经系统感染的典型表现,但少部分细胞数中度至重度增高,可与其他疾病混淆,值得引起重视。 Objective To explore the clinical and etiological characteristics of hand-foot-mouth disease complicated with intracranial infection and provide the basis for the early diagnosis and treatment of the disease. Methods The clinical data of 43 children with HFMD complicated with intracranial infection (intracranial infection group) and 45 hospitalized HFMD children (control group) were retrospectively analyzed. Results Hand, foot and mouth disease with intracranial infection accounted for 1.36% of the total number of patients with hand-foot-mouth disease in the same period. May-August was the peak of onset. Compared with the control group, the fever time of children with intracranial infection was prolonged (P <0.01) (P <0.05), peripheral blood leukocyte count increased (P <0.05), arterial systolic blood pressure and fasting blood glucose level increased (P <0.01). There was no significant difference in age and sex between the two groups (All P> 0.05). Among the cases of intracranial infection, brain stem encephalitis accounted for 51.16% (22/43). Children with encephalitis encephalitis accounted for 95.45% (21/22) under 5 years of age, compared with other age groups, the difference was statistically significant (P <0.05). Cerebrospinal fluid in children with intracranial infection there is abnormal cerebrospinal fluid pressure and cell number. Etiological examination, clear EV71 infection in 29 cases (67.44%), identified as coxsackie virus A16 infection in 5 cases (11.63%), 9 cases did not clearly associated pathogens. There was no significant difference in EV71 infection rate between children with brainstem encephalitis and other types of children with intracranial infection (P> 0.05). Conclusions Children with HFMD should be alert to combined intracranial infection, especially those with atypical rashes, such as high fever, high blood pressure, increased peripheral blood leukocyte count, and elevated blood sugar. EV71 is the hospital admitted HFMD children with intracranial infection of the main pathogens. Children younger than 5 years of age are susceptible to encephalitis encephalitis. Cytological examination of cerebrospinal fluid most of the typical performance of the virus with central nervous system infection, but a small number of cells moderate to severe increase, confused with other diseases, deserves attention.