预后取决于胃炎潜在的病因和类型。
糜烂性胃炎
停止或减少致病物质(例如,非甾体抗炎药 [NSAID]/酒精)暴露后,症状通常改善。[3]Glickman JN, Antonioli DA. Gastritis. Gastrointest Endosc Clin N Am. 2001;11:717-740.http://www.ncbi.nlm.nih.gov/pubmed/11689363?tool=bestpractice.com[30]Moayyedi PM, Lacy BE, Andrews CN et al. ACG and CAG Clinical Guideline: Management of Dyspepsia. Am J Gastroenterol. 2017;112(7):988-1013.https://www.nature.com/articles/ajg2017154http://www.ncbi.nlm.nih.gov/pubmed/28631728?tool=bestpractice.com
幽门螺杆菌感染
虽然社区治疗的根除率远低于临床试验,但是预后还是较好。[4]Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. Am J Gastroenterol. 2017;112(2):212-239.https://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/28071659?tool=bestpractice.com 初始选择传统的三联治疗方案可能不够,患者可能需要选择铋剂为基础的四联方案。[4]Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. Am J Gastroenterol. 2017;112(2):212-239.https://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/28071659?tool=bestpractice.com
自身免疫性胃炎
用氰钴胺进行替代治疗后,B₁₂ 缺乏症的预后极佳。发生胃腺癌和胃部类癌肿瘤的风险轻度增加。[77]Hsing AW, Hansson LE, McLaughlin JK, et al. Pernicious anemia and subsequent cancer: a population-based cohort study. Cancer. 1993 Feb 1;71(3):745-50.http://www.ncbi.nlm.nih.gov/pubmed/8431855?tool=bestpractice.com[78]Burkitt MD, Pritchard DM. Review article: pathogenesis and management of gastric carcinoid tumours. Aliment Pharmacol Ther. 2006;24:1305-1320.http://www.ncbi.nlm.nih.gov/pubmed/17059512?tool=bestpractice.com
化脓性胃炎
接受手术治疗的患者死亡率为20%(2/10),接受药物治疗患者的死亡率为50%(13/26)。[79]Kim GY, Ward J, Henessey B, et al. Phlegmonous gastritis: case report and review. Gastrointest Endosc. 2005;61:168-174.http://www.ncbi.nlm.nih.gov/pubmed/15672083?tool=bestpractice.com