Abstract: Objective    To explore the clinical value of fractional exhaled nitric oxide in monitoring airway inflammation in children with different allergic types of asthma. Methods    This was a retrospective study. The clinical data ofasthma children aged from 6 to 18 years were collected，who visited Shanghai Children’s Hospital，School of Medicine，Shanghai Jiao Tong University from March 2020 to March 2023. The patients were divided into different groups according to allergen results：inhalant allergy group （inhalation group），food allergy group （food group），mixed allergy group （mixed group），and allergen-negative group （control group）. The differences in fractional expiratory nitric oxide levels among the groups were compared，and stratification analysis was made concerning asthma control，recent infection and history of rhinitis. Results    The study included 487 children with asthma with allergen information，328 boys and 159 girls，including 455 allergen-positive children，among whom 238 children were in inhalationgroup，36 children in food group，181 in mixed group and 32 children in control group. FeNO50 and FeNO200 in inhalation group and mixed group were significantly higher than those in food group and control group（P<0.001）. CaNO was not different among the groups（P> 0.05）. Under the conditions such as good control of asthma，no infection，and combination with rhinitis，FeNO50 and FeNO200 were significantly higher in the inhalation group and the mixed group than in the food group and the control group（P<0.05）. CaNO was higher in the inhalation group and the mixed group than in the food group among the children with good asthma control and combination with rhinitis（P< 0.05）. Conclusion    FeNO50 and FeNO200 are significantly higher in the inhalation group and the mixed group than in the food group and the control group. CaNO is not different among the groups. FeNO50，FeNO200 and CaNO are significantly increased in children with inhalant and mixed allergic asthma who are well-controlled and with a history of rhinitis，and the airway inflammatory response is more obvious. Fractional exhaled nitric oxide better reflects and monitors the severity of airway inflammation in children with inhalant allergy asthma and mixed allergy asthma，which can be a guide for adjusting diagnostic and therapeutic strategies.

Key words: allergic asthma, allergen, child, fractional exhaled nitric oxide, airway inflammation

摘要： 目的    研究口呼出气一氧化氮在监测不同过敏类型哮喘儿童气道炎症中的临床价值。方法    回顾性研究，收集2020年3月至2023年3月在上海交通大学医学院附属儿童医院呼吸科门诊就诊的6～18岁哮喘患儿临床资料，按过敏原结果分组：吸入性过敏组（吸入组）、食物性过敏组（食物组）、混合性过敏组（混合组）和过敏原阴性组（对照组）。比较四组间口呼出气一氧化氮水平差异，并对哮喘控制、近期感染及鼻炎史等因素并进行分层分析。结果    纳入487例有过敏原资料的哮喘患儿，男328例、女159例，过敏原阳性共455例，其中吸入组238例，食物组36例，混合组181例，对照组32例。吸入组、混合组的一氧化氮（FeNO）50、FeNO200较食物组、对照组升高（P<0.001），肺泡-氧化氮浓度（CaNO）在不同组间差异无统计学意义（P>0.05）。在哮喘控制良好、无感染、合并鼻炎等临床状态下，吸入组、混合组的FeNO50、FeNO200较食物组、对照组显著升高（P<0.05）。CaNO在哮喘控制良好、合并鼻炎患儿中，吸入组和混合组均高于食物组（P<0.05）。结论    吸入组和混合组的FeNO50、FeNO200水平显著高于食物组和对照组，CaNO组间无明显差异，但FeNO50、FeNO200、CaNO在哮喘控制良好且有鼻炎史的吸入性和混合性过敏哮喘患儿中均有显著升高，气道炎症反应更为明显。口呼出气一氧化氮较好地反映并监测吸入性过敏和混合性过敏的哮喘患儿的气道炎症情况，对调整诊治策略有指导作用。

关键词: 过敏性哮喘, 过敏原, 儿童, 口呼出气一氧化氮, 气道炎症