美国胃肠病学院 (American College of Gastroenterology) 指南现在建议，无论何时发现和治疗幽门螺杆菌感染，都应对患者进行根除检查。可使用尿素呼气试验、粪便抗原检测或基于活检的检查确定幽门螺杆菌是否已根除。[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 一项研究表明，血清生物标志物（例如胃蛋白酶原 I 和 II、胃泌素-17 和幽门螺杆菌 IgA/IgG 抗体 [胃黏膜状态标记物]）作为一种无创检测方式来诊断胃体萎缩有很高的准确性，而胃体萎缩在普通人群中很常见，[84]Storskrubb T, Aro P, Ronkainen J, et al. Serum biomarkers provide an accurate method for diagnosis of atrophic gastritis in a general population: the Kalixanda study. Scand J Gastroenterol. 2008;43:1448-1455.http://www.ncbi.nlm.nih.gov/pubmed/18663663?tool=bestpractice.com但目前尚不清楚这些标志物的临床作用。[85]van Marrewijk CJ, van Oijen MG, Paloheimo LI, et al. Influence of gastric mucosal status on success of stepwise acid suppressive therapy for dyspepsia. Aliment Pharmacol Ther. 2009;30:82-89.http://www.ncbi.nlm.nih.gov/pubmed/19309389?tool=bestpractice.com
非甾体类抗炎药（NSAID）/酒精相关的糜烂性胃炎对症治疗效果很差的患者，需要进行内镜检查并取活检。[32]Park WG, Shaheen NJ, Cohen J, et al. Quality indicators for EGD. Gastrointest Endosc. 2015;81(1):17-30.https://www.giejournal.org/article/S0016-5107(14)02050-1/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/25480101?tool=bestpractice.com
对于弥漫性萎缩性胃炎合并维生素 B₁₂ 缺乏的患者，需要通过血清维生素 B₁₂ 水平、甲基丙二酸水平或同型半胱氨酸水平检测进行密切随访，以评估治疗效果。[24]Toh BH, van Driel IR, Gleeson PA. Pernicious anemia. N Engl J Med. 1997;337:1441-1448.http://www.ncbi.nlm.nih.gov/pubmed/9358143?tool=bestpractice.com
与萎缩性胃炎和/或自身免疫性胃炎相关的胃腺癌和类癌肿瘤的风险尚不确定；然而，萎缩性全胃炎、胃体的严重肠上皮化生以及年龄＞50 岁均会增加萎缩性胃炎患者发生胃肿瘤性病变的风险。[86]Vannella L, Lahner E, Osborn J, et al. Risk factors for progression to gastric neoplastic lesions in patients with atrophic gastritis. Aliment Pharmacol Ther. 2010;31:1042-1050.http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2010.04268.x/fullhttp://www.ncbi.nlm.nih.gov/pubmed/20175768?tool=bestpractice.com
