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目的:探讨尘肺病患者的肺功能变化特点及其可能的影响因素。方法:于2019年12月，选取2015年12月至2016年12月在湖南省职业病防治院职业病四科住院的尘肺病患者265例为研究对象，完善肺功能检查，包括用力肺活量（FVC）、FVC%、第1秒用力呼气容积（FEV1）、FEV1%、第1秒用力呼气容积占用力肺活量比值（FEV1/FVC）、肺一氧化碳弥散量百分比（DLCO%）、用力呼气余75%、50%、25%肺活量的瞬间流量百分比（MEF75%、MEF50%、MEF25%），收集其年龄、吸烟史等资料，并进行慢性阻塞性肺疾病自评问卷（CAT）评分，3年后对其进行随访，分析肺功能指标3年下降率及其与尘肺病期别、年龄、吸烟指数、起始肺功能值、CAT评分的关系。结果:265例尘肺病患者与入选时比较，随访3年后9个肺功能指标值均明显下降，差异均有统计学意义（n P<0.05）。FEV1%、FEV1/FVC、MEF75%、MEF50%、MEF25%下降率与尘肺病期别呈正相关（n r=0.250、0.290、0.219、0.280、0.141，n P<0.05）；FEV1%和MEF75%下降率与吸烟指数呈正相关（n r=0.148、0.152，n P<0.05）；DLCO%和MEF25%下降率与其起始肺功能值呈正相关（n r=0.276、0.153，n P<0.05）；FEV1%、FEV1/FVC和MEF50%下降率与其起始肺功能值呈负相关（n r=-0.215、-0.146、-0.214，n P<0.05）；FVC%、FEV1%、MEF75%和MEF50%下降率与CAT评分变化值呈正相关（n r=0.147、0.208、0.210、0.196，n P<0.05）。二元logistic回归显示，高龄、高初始DLCO%值是DLCO%下降率的危险因素（n OR=1.105、1.078，n P<0.05）；高吸烟指数是MEF75%下降率的危险因素（n OR=1.016，n P<0.05）；尘肺病期别高、CAT评分增加是MEF50%下降率的危险因素（n OR=1.548、1.162，n P<0.05）；高初始MEF25%值是MEF25%下降率的危险因素（n OR=1.010，n P<0.05）。n 结论:尘肺病患者3年肺功能指标下降明显，尘肺病期别、年龄、吸烟指数和肺功能损伤程度与肺功能下降速率有关。“,”Objective:To investigate the characteristics of pulmonary function changes and its possible influencing factors in patients with pneumoconiosis.Methods:In December 2019, pneumoconiosis patients hospitalized in four departments of occupational diseases in Hunan Occupational Disease Prevention and Control Hospital from December 2015 to December 2016 were selected as subjects. Lung function including forced vital capacity (FVC) , FVC%, forced expiratory volume in one second (FEV1) , FEV1%, forced expiratory volume in one second / forced vital capacity (FEV1/FVC) , diffusion capacity of the lung foe carbon monoxide% (DLCO%) 、maximal expiratory rlow 75% (MEF75%) , maximal expiratory rlow 50% (MEF50%) and maximal expiratory rlow 25% (MEF25%) were tested, and collect their age, occupation history, smoking history and Chronic Obstructive Pulmonary Disease Self Rating Questionnaire (CAT) score. They were followed up after 3 years to analyze the 3-year decline rates of lung function indicators and their relationship with stage of pneumoconiosis, age, smoking index, baseline values of lung function and CAT score.Results:265 cases were studied effectively. After 3 years, the values of 9 lung function indicators of pneumoconiosis patients were significantly lower than those of 3 years ago (n P<0.05) . The decline rates of FEV1%, FEV1/FVC, MEF75%, MEF50% and MEF25% were positively correlated with the stage of pneumoconiosis (n r=0.250, 0.290, 0.219, 0.280, 0.141, n P<0.05) . The decline rates of FEV1% and MEF75% were positively correlated with smoking index (n r=0.148, 0.152, n P<0.05) . The decline rates of DLCO% and MEF25% were positively correlated with the baseline value of initial pulmonary function (n r=0.276, 0.153, n P<0.05) , while the decline rates of FEV1%, FEV1/FVC and MEF50% were negatively correlated with the baseline values of initial pulmonary function (n r=-0.215, -0.146, -0.214, n P<0.05) . The decline rates of FVC%, FEV1%, MEF75% and MEF50% were positively correlated with the changes of CAT scores (n r=0.147, 0.208, 0.210, 0.196, n P<0.05) . Logistic regression analysis showed that old age and high initial value of DLCO% were the risk factor for the decline of DLCO% (n OR=1.105、1.078, n P<0.05) .High smoking index was the risk factors for the decline of MEF75% (n OR=1.016, n P<0.05) . High stage and the increase of CAT score were the risk factors for the decline of MEF50% (n OR=1.548, 1.162, n P<0.05) . High initial value of MEF25% was the risk factor for the decline of MEF25% (n OR=1.010, n P<0.05) .n Conclusion:The pulmonary function index of pneumoconiosis patients declined significantly in 3 years. The stage of pneumoconiosis, age, smoking index and degree of pulmonary function damage were related to the decline rate of pulmonary function.