Albert Einstein College of Medicine, Bronx, NY, USA.
J Am Med Dir Assoc. 2011 Jun;12(5):337-43. doi: 10.1016/j.jamda.2010.04.009. Epub 2010 Oct 2.
Vital signs are objective measures of physiological function that are used to monitor acute and chronic disease and thus serve as a basic communication tool about patient status. The purpose of this analysis was to review age-related changes of traditional vital signs (blood pressure, pulse, respiratory rate, and temperature) with a focus on age-related molecular changes, organ system changes, systemic changes, and altered compensation to stressors. The review found that numerous physiological and pathological changes may occur with age and alter vital signs. These changes tend to reduce the ability of organ systems to adapt to physiological stressors, particularly in frail older patients. Because of the diversity of age-related physiological changes and comorbidities in an individual, single-point measurements of vital signs have less sensitivity in detecting disease processes. However, serial vital sign assessments may have increased sensitivity, especially when viewed in the context of individualized reference ranges. Vital sign change with age may be subtle because of reduced physiological ranges. However, change from an individual reference range may indicate important warning signs and thus may require additional evaluation to understand potential underlying pathological processes. As a result, individualized reference ranges may provide improved sensitivity in frail, older patients.
生命体征是用于监测急性和慢性疾病的生理功能的客观测量指标，也是患者状况基本沟通工具。本分析旨在回顾传统生命体征（血压、脉搏、呼吸频率和体温）的年龄相关性变化，重点关注与年龄相关的分子变化、器官系统变化、全身变化以及对压力源的代偿改变。综述发现，许多生理和病理变化可能随年龄而发生，并改变生命体征。这些变化往往会降低器官系统适应生理压力源的能力，尤其是在体弱的老年患者中。由于个体的年龄相关生理变化和合并症的多样性，单点生命体征测量在检测疾病过程中的敏感性较低。然而，连续的生命体征评估可能具有更高的敏感性，特别是在个体化参考范围下观察时。由于生理范围缩小，生命体征随年龄的变化可能不明显。然而，从个体参考范围的变化可能表明重要的警告信号，因此可能需要进一步评估以了解潜在的病理过程。因此，个体化参考范围可能为体弱的老年患者提供更好的敏感性。
