目的探讨血清胃蛋白酶原(PG)含量动态变化规律及其意义。方法对辽宁庄河胃癌高发区444例胃癌筛查受检者,在初检和随访时,分别利用酶联免疫吸附试验(ELISA)方法进行血清PGⅠ、PGⅡ含量检测,并计算PGⅠ/Ⅱ比值;利用胃镜及胃黏膜组织病理学检查进行胃疾病诊断;利用胃黏膜HE染色和幽门螺杆菌(Hp)抗体检测两种方法联合判定Hp感染情况。结果(1)以≤40岁、41~50岁、51~60岁和≥61岁进行年龄分组,各年龄组中仅51~60岁组,随访6个月PGⅡ变化率(0.84)显著低于12个月(1.22,P=0.019)和30个月组(1.24,P=0.004),PGⅠ/Ⅱ比值变化率(1.09)显著高于后两组(0.75、P=0.027,0.69、P=0.001)。(2)浅表性胃炎(SG)减轻组随访6个月PGⅠ变化率(0.69)显著低于12个月(0.97,P=0.002);萎缩性胃炎(AG)减轻组随访6个月PGⅠ/Ⅱ变化率(1.13)显著高于30个月(0.75,P=0.042)。(3)SG→NOR(正常)组PGⅠ变化率(0.94)显著高于SG→AG组(0.79,P=0.022);AG→NOR组PGⅠ、PGⅡ变化率(0.43、0.60)均显著低于AG→SG组(0.87、P=0.000,1.11、P=0.010)。(4)Hp阴性→阳性组PGⅠ变化率(0.94)显著高于阴性→阴性组(0.81,P=0.026);阳性→阴性组PGⅠ、PGⅡ变化率(0.74,0.86)显著低于阳性→阳性组(0.93、1.15,均P=0.000),PGⅠ/Ⅱ比值变化率(0.90)显著高于后者(0.70,P=0.022)。结论血清PG变化率与随访时间、受检者胃疾病性质及Hp感染状态的变化密切相关。血清PG含量动态检测可用于胃癌高危人群监测。 Objective To investigate the dynamic changes of serum pepsinogen (PG) content and its significance. Methods 444 cases of gastric cancer screening in Zhuanghe high incidence area of ​​Liaoning Province were enrolled. At the initial examination and follow - up, the levels of PG Ⅰ and PG Ⅱ were detected by enzyme linked immunosorbent assay (ELISA), and the ratio of PG Ⅰ / Ⅱ was calculated. Gastroscopy and gastric mucosa histopathological examination for the diagnosis of gastric disease; gastric mucosa HE staining and detection of Helicobacter pylori (Hp) antibody detection of two methods to determine the Hp infection. Results (1) The age groups of ≤40, 41-50, 51-60 and ≥61 years old were only 51 to 60 years old in each age group. The change rate of PG Ⅱ (0.84) at 6 months follow-up was significantly lower than The change rate of PGⅠ / Ⅱ ratio (1.09) in 12 months (1.22, P = 0.019) and 30 months group was significantly higher than that in the latter two groups (0.75, P = 0.027, 0.69, P = 0.001 ). (2) The rate of change of PGI at 6 months follow-up was significantly lower than that at 12 months in superficial gastritis (SG) group (0.97, P = 0.002) Ⅱ rate of change (1.13) was significantly higher than 30 months (0.75, P = 0.042). (3) The change rate of PG Ⅰ in SG → NOR group was significantly higher than that in SG → AG group (0.79, P = 0.022). The change rates of PG Ⅰ and PG Ⅱ in AG → NOR group were significantly lower than those in AG group → SG group (0.87, P = 0.000, 1.11, P = 0.010). (4) The rate of change of PG Ⅰ in Hp negative → positive group was significantly higher than that in negative → negative group (0.81, P = 0.026). The positive rates of PG Ⅰ and PG Ⅱ in positive → negative group were significantly lower than those in positive → positive group (0.93, 1.15, P = 0.000). The rate of change of PGⅠ / Ⅱ ratio (0.90) was significantly higher than that of the latter (0.70, P = 0.022). Conclusions The change rate of serum PG is closely related to the follow-up time, the nature of gastric disease and the status of Hp infection in the subjects. Dynamic detection of serum PG levels can be used for monitoring at high risk of gastric cancer.