目的·分析哮喘（asthma，AS）合并变应性鼻炎（allergic rhinitis，AR）儿童在AS不同临床分期下不同AR严重程度时的鼻呼出气一氧化氮（fractional concentration of nasally exhaled nitric oxide，FnNO）、口呼出气一氧化氮（fractional concentration of exhaled nitric oxide，FeNO）水平，为指导临床诊治提供依据。方法·纳入2021年4月至11月期间于苏州大学附属儿童医院呼吸科确诊为AS合并AR的儿童，选取同期至儿保科正常体检的健康儿童作为对照组。所有入组儿童均行FeNO、FnNO、外周血嗜酸细胞（eosinophil，EOS）检测，以评估患儿的病情严重程度。对比分析AS合并AR的儿童在AS不同临床分期下不同AR严重程度时的FeNO、FnNO水平及其与肺功能的相关性。结果·哮喘急性发作期儿童中鼻炎持续中重度的比例更高，哮喘临床缓解期儿童中的鼻炎间歇轻度比例更高。哮喘急性发作期的FeNO值高于慢性持续期、临床缓解期（调整后P=0.022、P=0.000），慢性持续期高于临床缓解期（调整后P=0.002）；哮喘急性发作期FnNO值高于临床缓解期（调整后P=0.044）。哮喘慢性持续期中，鼻炎持续轻度组及持续中重度组的FnNO水平高于间歇轻度组（调整后P=0.001、P=0.000）。在临床缓解期中，鼻炎持续轻度组及持续中重度组的FnNO水平高于间歇轻度组（调整后P=0.001、P=0.007）。在鼻炎间歇轻度组中，急性发作期的FnNO高于慢性持续期及临床缓解期（调整后P=0.010、P=0.019）。哮喘急性发作期的部分肺功能指标与FeNO、FnNO水平具有一定负相关性（均P<0.05），而慢性持续期的FEV₁/pred 与FeNO水平具有一定负相关性（P=0.010）。结论·AS急性发作期儿童的FeNO、FnNO水平更高，且AR症状积分更高；AS合并AR儿童的FeNO、FnNO水平与肺功能指标呈负相关。

Objective ·To determine the levels of nasally exhaled nitric oxide (FnNO) combined with fractional concentration of exhaled nitric oxide (FeNO) in children with asthma (AS) complicated with allergic rhinitis (AR), and analyze the levels of FnNO and FeNO in different clinical stages of AS with different severities of AR, so as to provide basis for guiding clinical diagnosis and treatment. Methods ·Children diagnosed with AR with AS in the Department of Respiratory and Otolaryngology of Children's Hospital of Soochow University from April 2021 to November 2021 were included, and healthy children who visited the Department of Pediatrics for normal physical examination during the same period were enrolled as the control group. FeNO and FnNO were measured in all children to assess the severity of the children's diseases. The levels of FeNO and FnNO in children with AR and AS at different clinical stages of AS and their correlation with pulmonary function were compared and analyzed. Results ·The proportion of persistent moderate-to-severe rhinitis was higher in the acute exacerbation stage of AS, and the proportion of intermittent mild rhinitis was higher in the clinical remission stage of AS. The FeNO level in the acute exacerbation stage were higher than that in the chronic persistent stage and clinical remission stage of AS (adjusted P=0.022, 0.000), and higher in the chronic persistent stage than that in the clinical remission stage of AS (adjusted P=0.002). The FnNO level in the acute exacerbation stage was higher than that in the clinical remission stage of AS (adjusted P=0.044). In the chronic persistent stage of AS, the FnNO levels in the persistent mild group and persistent moderate-to-severe control group were higher than those in the intermittent mild group (adjusted P=0.001, 0.000). In the clinical remission stage of AS, the FnNO levels in the persistent mild group and persistent moderate to severe control group were higher than those in the intermittent mild group (adjusted P=0.001, 0.007). In the intermittent mild group of AR, the FnNO levels in the acute exacerbation stage were higher than those in the chronic persistent stage and clinical remission stage of AS (adjusted P=0.010, 0.019). Part of pulmonary functions in the acute exacerbation stage of AS children were negatively correlated with the FeNO and FnNO levels (all P<0.05), while FEV₁/pred in the chronic persistent stage was negatively correlated with FeNO level (P=0.010). Conclusion ·FeNO and FnNO levels increased in the acute exacerbation stage of AS, and symptom scores of AR also increased. FeNO and FnNO levels were negatively correlated with pulmonary function in AS with AR children.