诊断
体检包括医生用听诊器仔细听诊您的肺部呼吸音。为了区分非感染性肺炎和其他肺部疾病，您可能需要进行以下一项或多项检查。
血液检测
可以做一些血液检测以帮助确诊。
影像学检查
影像学检查用处很大，因为在大多数情况下，感染性肺炎只影响肺部的局部小区域，而不具备传染性的非感染性肺炎的影响通常会扩散到肺部的所有五个肺叶。
- 胸部 X 线检查。在这种无痛检查中，少量辐射会通过胸部，生成肺部的图像。X 线检查只需要几分钟。
- 计算机断层成像（CT）。CT 扫描将从许多不同角度拍摄的 X 线图像结合成详细的横截面图像。做这种无痛检查时，您需要躺在狭窄的长台上，随后滑入一台大型的环形机器中。CT 扫描通常不到 15 分钟就能完成。计算机断层成像能提供比胸部 X 线检查更详细的肺部变化。
肺功能检查
“肺量计法”检查可测量您在特定时间段内可吸入和呼出的空气量。医生还可能会测量肺部在运动过程中将外界气体转移到血液中的效率。
评估肺部工作状况的另一种方法是使用血氧仪来测量血液中的氧气含量。血氧仪可以夹在手指上，毫无痛感。
支气管镜检查
支气管镜检查是一种利用旋入咽喉的软管观察气道并采集肺部样本的方法。
在支气管镜检查期间，医生可能用盐水溶液冲洗肺的某一部分，收集肺细胞和其他材料。这种冲洗程序称为灌洗。医生还可能通过窥镜插入一个小工具，从肺组织取出一小部分细胞样本供测试。
外科肺活检
在某些情况下，您的医生可能需要检查您肺部几个部位的大样本组织，这些组织无法通过支气管镜检查。可能需要外科手术来获取这些样本。
治疗
如果您有过敏性或化学性非感染性肺炎，您的医生会建议您不要接触过敏原或刺激肺部的化学物质。该措施应该有助于减轻您的症状。
在严重非感染性肺炎病例中，治疗还可包括：
- 皮质类固醇。这些药物通过抑制您的免疫系统和减少肺部炎症而起作用。皮质类固醇通常作为药丸服用。然而，长期使用皮质类固醇也会增加感染的风险，并与骨骼变薄（骨质疏松症）有关。
- 氧疗。如果您的呼吸很困难，您可能需要通过面罩或带有与您的鼻孔吻合的插孔的塑料管进行氧气治疗。有些人经常需要氧气治疗，而有些人可能只在运动或睡觉时才需要。
Hypersensitivity pneumonitis
If you have pneumonitis caused by chemical irritation or an allergic reaction, your healthcare professional will likely recommend stopping the exposure that's irritating your lungs. This step should help lessen your symptoms.
Ways you can lower exposure include:
- Avoiding the triggering substance, if known. This may even mean choosing a different job or hobby if your condition is severe.
- Wearing protective gear. Face protection that filters out particles, such as a pollen mask or a personal dust respirator, may lessen exposure.
- Improving ventilation. Better airflow in the area with the substance causing your symptoms may lessen your exposure.
- Limiting mold growth. Cleaning places mold can grow, such as in hot tubs, ventilation systems and humidifiers, may avoid exposure. Remove water-damaged carpet, furniture and drywall.
Corticosteroid medicines work by calming your immune system's reaction to an irritation. This can make your lungs less inflamed. Corticosteroids are usually taken as a pill for a limited time. Long-term corticosteroid use raises your risk of developing infections and is linked with thinning of bones called osteoporosis. Other medicines that lessen your immune system's response may be used.
Sometimes corticosteroids using an inhaler may help. You breathe these medicines into your lungs. The medicines lessen inflammation in your airway so that it's easier to breathe.
Bronchodilators are medicines that also usually come in inhalers. These medicines relax the muscles around your airways. This can help relieve coughing and make breathing easier.
Drug-induced pneumonitis
Treatment for pneumonitis caused by medicines depends on how severe symptoms are. If symptoms are mild, you may not need any treatment. If your symptoms are severe, treatment with mainly corticosteroids, but sometimes other medicines that lessen your immune system's reaction, may help. Sometimes your healthcare professional may decide to stop or change medicines that are causing the inflammation.
Radiation-induced pneumonitis
If symptoms are mild, you may not need treatment for radiation pneumonitis. Severe symptoms are usually treated with corticosteroids.
Treatment options for any cause of pneumonitis
When pneumonitis is severe, treatment also may include:
- Oxygen therapy. If you're having a lot of trouble breathing, you may need oxygen therapy through a mask or through a plastic tubing with tips that fit into your nose. You may use oxygen when you sleep or exercise. But some people need oxygen all the time. Carrying a small tank of oxygen or using a portable oxygen concentrator can help you be more mobile.
- Pulmonary rehabilitation. Pulmonary rehabilitation can help manage your symptoms and improve your ability to do daily tasks.
- Lung transplant. Severe lung damage may require a lung transplant.
生活方式与家庭疗法
诊断为非感染性肺炎，可能意味着您必须改变自己的生活方式以保护自身健康。您需要尽可能避开已知诱因。
例如，倘若您在工作中需要接触刺激肺部的物质，请与医生和职场上司讨论自我保护方式，例如佩戴防花粉面罩或个人防尘呼吸器。如果某种爱好会引发这种问题，您可能需要改变爱好。
准备您的预约
虽然您最初可能会去看家庭医生，但其可能会将您转诊至专门治疗肺部疾病的医生（肺科医生）。
您可以做什么
您可能想写一份清单，它包括：
- 症状详述，包括症状何时开始以及是否有什么看似加重症状或使好转
- 详细列出伴随这些职业活动的所有工作和暴露情况
- 关于您已患医学疾病及其治疗的信息
- 关于您父母或兄弟姐妹的医学疾病信息
- 您服用或近几年服用过的所有药物和膳食补充剂？
- 要问医生的问题
医生可能做些什么
完整的病史和体检能提供重要线索，查清可能是什么导致您的症状。医生可能询问以下一些问题：
- 您目前或者之前抽烟吗？
- 您从事哪类工作或有哪些爱好？
- 和您工作或爱好相关的呼吸症状有多严重？
- 您家有热水浴池或加湿器吗？
- 您周围有鸽子或宠物鸟吗？