The Innovation Materials 智能可穿戴血壓監測將何去何從？

導 讀

持續主動的血壓監測有助於心血管功能的實時評估和心血管疾病的早期診斷，先進的柔性電子技術和人工智能算法為血壓的實時監測和異常數據挖掘提供了便利。然而，當前獲得國際官方認證和臨床應用批準的可穿戴血壓監測設備相對較少，仍需要各行各業的協同努力，促進可穿戴血壓監測設備的市場化與臨床應用。

圖1 圖文摘要

心血管疾病是全球主要的健康挑戰之一，每年導致數百萬人死亡，約占全球死亡人數的三分之一。主動、持續和可靠的血壓監測可以有效降低睡眠呼吸暫停、中風或高血壓引起的心血管系統相關死亡的風險，進而提供健康保障和提高生活質量。此外，精準的血壓監測在早期診斷、心血管風險分類和實施最佳治療策略等方面起著關鍵作用。

在連續非侵入性血壓監測領域中，使用可穿戴設備的技術正在快速發展，越來越多的醫療從業者、科研人員和企業參與到由臨床需求和技術進步共同推動的血壓監測項目中。可穿戴設備必須保證穿戴舒適、不限制人體自由活動，並且操作簡便，以確保有效的長期監測。用戶的適應性和正確穿戴(如設備放置不當、合適程度和佩戴時間等因素)，對於血壓測量和管理的準確性和可靠性方面起著關鍵作用。目前，通過克服與材料、工程設計、力學、數據處理方法和集成策略等相關的挑戰，實現真正的適用於日常的可穿戴血壓監測設備正在成為現實。

2023年8月11日，清華大學的研究團隊在《科學進展》雜志上報道了一項智能可穿戴血壓監測系統。該系統通過將柔性應變傳感器陣列與深度學習神經網絡相結合，實現了血壓和心臟功能的監測評估。2023年8月17日，香港城市大學的研究人員報道了一種面向可穿戴連續無線監測動脈血壓的薄型、柔軟和微型化系統。該系統成功地集成了柔性壓電傳感器陣列、主動壓力適應單元、信號處理模塊和先進的機器學習技術。初步試驗包括87名志願者，並對兩名高血壓患者進行了臨床跟蹤，驗證了可穿戴系統在實現精確血壓監控和個性化診斷方面的可靠性、可行性和實際可用性。因此，將先進的柔性電子技術與人工智能算法相結合，可以促進血壓的精準監測。

2023《中國高血壓防治指南》首次推薦將可穿戴設備作為血壓監測的工具。HUAWEI WATCH D已獲得國際認證，將智能可穿戴設備用於血壓管理。此外，Galaxy Watch 5也能夠測量血壓。然而，為了保證測量的準確性，用戶需要每個月使用傳統的袖帶方式對可穿戴設備進行校準。盡管如此，三星的官方聲明，Galaxy Watch 5的血壓功能不能用於診斷高血壓或檢測心臟病發作的跡象。由於這種血壓測量功能尚未獲得美國食品藥品監督管理局（FDA）的批準，從而阻礙了可穿戴設備的臨床應用。

彌合基礎研究與市場應用之間的差距涉及多個方面。技術上，與固定的袖帶設備相比，可穿戴傳感器的功能尚未達到普遍接受的水平。涵蓋靈敏度、線性度和批次一致性的綜合傳感參數對於獲取高保真度的與血壓相關的信號至關重要。同時，開發強大且抗幹擾的可穿戴傳感器與人體皮膚之間的接口可以減少日常活動中的運動偽影。利用人工智能算法進行血壓相關特征的精確提取，有助於減少數據處理、傳輸和能耗的負擔。此外，應提出一種涉及材料、機械、醫學、電子和工程科學的多學科方法，以實現可穿戴傳感器與可穿戴設備結構的無縫集成。將可穿戴血壓監測設備有效地整合到現有醫療系統中也是一個挑戰。這涉及與電子健康記錄系統的兼容性、與醫療專業人員的合作以及納入臨床指南。建立標準和協議是確保不同可穿戴設備之間一致可靠測量的必要條件。

縮短可穿戴血壓監測設備的基礎研究和市場應用之間的差距需要克服技術、監管、標準化、商業化和醫療整合等方面的挑戰。研究人員、行業利益相關者、監管機構和醫療專業人員之間的合作努力對於克服這些障礙並確保當前科學研究成果成功轉化為實際可應用的產品至關重要。

總結與展望

心血管疾病每年造成數百萬人死亡，高精度、可靠的血壓監測在早期診斷心血管疾病風險中起著關鍵作用。可穿戴設備在無創血壓監測領域正在迅速發展，智能可穿戴血壓監測提供了便捷、連續、實時的監測、反饋和警報，以便於人們對早期心血管疾病的發現和管理。但基礎研究和市場應用之間的差距涉及方方面面，可穿戴設備在血壓監測中的運用需要在研究人員、行業之間的合作努力，監管機構和醫療保健專業人員克服重要障礙，共同合作研究出實用、適用的產品。

責任編輯

孫林鋒   北京理工大學

李   琳   天津師范大學

本文內容來自The Innovation姊妹刊The Innovation Materials第1卷第3期以News & Buzz發表的“Smart wearable technologies for continuous and proactive blood pressure monitoring” (投稿: 2023-09-03；接收: 2023-11-09；在線刊出: 2023-11-13)。

DOI: https://doi.org/10.59717/j.xinn-mater.2023.100035

引用格式：Song Z., Chen M., Li W., et al., (2023). Smart wearable technologies for continuous and proactive blood pressure monitoring. The Innovation materials 1(3), 100035.

作者簡介

牛 利，博士生導師，中山大學長聘二級教授，廣州大學二級教授，廣州大學分析科學技術研究中心主任，廣州市傳感材料與器件重點實驗室主任，廣東省光電傳感材料與器件工程技術研究中心主任，廣州市青年科技工作者協會理事長，廣東省化學會分析化學專業委員會副主任。中國科學院“百人計劃”、國傢傑青、國傢高層次人才特殊支持計劃領軍人才、國傢科技部中青年科技創新領軍人才、國務院政府特殊津貼獲得者、英國皇傢化學會會士、俄羅斯工程院外籍院士、山東省泰山學者客座教授、福建省閩江學者講座教授、吉林省高級專傢、長春市有突出貢獻專傢、廣州市高層次人才傑出專傢、廣州市第十四屆政協委員。發表科研論文500餘篇，他引20000餘次，撰寫中英文專著4部。

宋忠乾，山東第一醫科大學副教授，碩士生導師，醫學人工智能與大數據學院生物醫學柔性電子實驗室課題組組長，泰山學者青年專傢，廣州市青年科技托舉人才計劃入選者。主要從事面向生物醫療應用的可穿戴柔性傳感器設計與集成研究，在ACS Nano，Nano Energy，iScience等期刊發表SCI論文50餘篇，總引用次數2000餘次，H-指數28，以第一發明人申請發明專利7項。主持國傢自然科學基金青年科學基金、中國博士後科學基金面上項目、廣州市“青年科技人才托舉工程”項目等多項。

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