Abstract: Objective: To explore the influence of esmolol on the myocardial enzymes in children with severe hand-foot-mouth disease( HFMD). Methods: One hundred and twenty cases of severe HFMD were randomly divided into routine therapy group( 65 cases) and esmolol group( 55 cases),and 45 healthy children were selected as normal control. The children in the routine therapy group were given antiviral to reduce the intracranial pressure and creatine phosphate sodium to protect myocardial cells. The children in the esmolol group were administered esmolol in addition to the routine therapy. The lactic dehydrogenase( LDH),creatine kinase( CK),phosphate kinase isozyme( CK-MB) and norepinephrine( NE) were detected at admission and checked again three days after treatment. The changes of the myocardial enzyme and NE were compared before and after the therapy. Results: The myocardial enzyme and NE were significantly higher in children with severe HFMD than that in the normal control( P 0. 01). In the routine therapy group and the esmolol group,the LDH,CK,CK-MB and NE decreased significantly after treatment( P 0. 01); the above indicators in the two groups had no significant differences before treatment( P 0. 05),but decreased significantly in the esmolol group after treatment( P 0. 01). Conclusions: The esmolol therapy can effectively reduce the myocardial injury in children with severe HFMD.