Abstract： Objective:To analyze the influence of nintedanib on pulmonary function, pulmonary fibrosis degree, serum platelet-derived growth factor (PDGF), prostaglandin E2 (PGE2), and serum transforming growth factor-β1 (TGF-β1) in patients with idiopathic pulmonary fibrosis (IPF).Methods:152 patients with IPF in the hospital were selected as the subjects from March 2019 to March 2023. 65 patients who were treated with routine treatment + pirfenidone were included in control group, and 87 patients who received nintedanib based on routine treatment were enrolled as observation group. The clinical efficacy and adverse reactions after treatment and pulmonary function indicators, vascular endothelial function indicators, pulmonary fibrosis degree and pro-fibrosis-related factors before and after treatment were compared between both groups.Results:After treatment, the total effective rate in observation group was higher than that in control group [85 cases(97.7%) vs. 58 cases(89.2%)] (P<0.05). There were no statistical differences in the adverse reactions between groups (P>0.05). The pulmonary function indicators and endothelial nitric oxide (NO) in both groups were enhanced after treatment than those before treatment, and FEV1[(2.05±0.23) vs. (1.88±0.27)]L, FVC[(2.14±0.21) vs. (1.93±0.27)]L, DLCO[(16.19±1.51) vs. (14.84±1.73)]ml/min·mmHg and NO[(825.10±98.37) vs. (746.01±77.78)]nmol/L were higher in observation group than those in control group (P<0.05). The pulmonary fibrosis degree, endothelin-1 (ET-1) and pro-fibrosis-related factors were reduced in the two groups compared with those before treatment, and Ⅳ C [(89.25±12.23) vs. (95.58±14.54)]ng/ml, HA[(185.44±23.01) vs. (197.23±27.17)]ng/ml, chest CT imaging score[(1.56±0.18) vs. (1.70±0.20)] points, ET-1[(57.78±10.05) vs. (70.14±10.53)]ng/L, PDGF[(136.85±61.07) vs. (217.47±67.12)] ng/L, PGE2[(258.57±50.28) vs. (329.28±71.43)]ng/L and TGF-β1 [(159.41±115.91) vs. (236.92±137.89)]ng/L in observation group were lower compared to control group (P<0.05).Conclusion:Nintedanib can effectively treat IPF, improve pulmonary function, vascular endothelial function indicators and pulmonary fibrosis degree, and reduce the levels of pro-fibrosis-related factors.