CN100407988C - 分析物监测装置和该装置的使用方法 - Google Patents

分析物监测装置和该装置的使用方法 Download PDF

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CN100407988C
CN100407988C CNB018227864A CN01822786A CN100407988C CN 100407988 C CN100407988 C CN 100407988C CN B018227864 A CNB018227864 A CN B018227864A CN 01822786 A CN01822786 A CN 01822786A CN 100407988 C CN100407988 C CN 100407988C
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亚当·赫里尔
史蒂文·M.·德瑞克尔
罗伯特·Y.·金
杰弗瑞·V.·范德尔布尔克
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Abbott Diabetes Care Inc
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Abstract

一种分析物监测器,包括探测器、探测器控制单元和显示器单元。该探测器具有例如基片、形成在基片上的凹陷的通道和位于凹陷的通道内的用于形成工作电极的导电材料。探测器控制单元典型地具有适于安放在皮肤上并适于容纳电化学探测器的一部分的护罩。探测器控制单元还包括位于护罩内的两个或多个导电触点,它被配置成可联接探测器上的两个或多个导电垫。发送器位于护罩内,并连接到多个导电触点,用于发送获自探测器的数据。显示器单元具有用于接收由探测器控制单元的发送器发送的数据的接受器,和连接到接收器用于显示分析物的水平读数的显示器。该分析物监测器可以是药物传输系统的一部分,用于根据获自探测器的数据调整分析物的水平。

Description

分析物监测装置和该装置的使用方法
技术领域
本发明总的来说涉及用于体内监测分析物(如葡萄糖或乳糖)的装置和方法。本发明尤其涉及用于使用电化学传感器体内监测分析物的装置和方法,以提供该病人的有关分析物水平的信息。
背景技术
葡萄糖或诸如乳糖或氧等其它分析物的水平对于一些个体的身体健康十分重要。葡萄糖或其它分析物水平的高或低可能会有不利影响。对于糖尿病患者来说,葡萄糖水平的监测非常重要,因为他们必须知道什么时候需要使用胰岛素以降低体内的葡萄糖水平,或者什么时候需要另外的葡萄糖以升高他们体内的葡萄糖水平。
由很多糖尿病患者采用的体内监测其血糖水平的常规技术包括定期抽血,将血液加到测试带上,然后利用比色法、电化学方法或光度计检测来确定血糖水平。这种技术不能连续或者自动地监测体内血糖水平,而是需要定期地用手动操作方式进行。不幸的是,血糖水平监测的稳定性在个体之间的变化很大。很多糖尿病患者发现定期测试很不方便,并且有时他们会忘记测试其血糖水平,或者没有时间进行适当的测试。另外,一些个体希望避免测试引起的疼痛。这些情况可能会导致高血糖或低血糖现象。一种能够连续或自动地监测体内血糖水平的葡萄糖探测器会使个体更容易地监测其血糖或其它分析物。
已经研发了很多装置用于连续或自动地监测血流或间质液中的分析物,如葡萄糖。很多这样的装置使用电化学探测器,它直接植入到病人的血管中或者皮下组织内。然而,这些装置经常难以大规模地再现性或价廉地生产。另外,这些装置一般较大、笨重,和/或不灵活,并且很多不能在受控的医疗设施如医院或医生的办公室之外有效地利用,除非限制病人活动。
一些装置包括探测器引导物,他放置在病人的皮肤上或靠靠近皮肤的位置上,并且可以绑附在病人身上以将探测器固定在原位。这些探测器引导物一般较笨重,不能自由移动。另外,探测器引导物或探测器包括用于将探测器连接到其他设备以将信号从探测器传输到分析仪的电缆或电线。探测器引导物的体积和电缆和电线的存在限制了方便地每天使用这些装置。因此需要一种小巧精致的装置,它能够不限制病人的运动和活动而操作探测器和提供信号到分析仪。
在设计延伸使用的探测器时,探测器在植入的同时病人的舒适度和活动范围是重要的考虑因素,其中所述探测器用于连续并自动地在体内监测分析物,如血糖的水平。需要一种小巧、便捷的装置,它可以连续地监测分析物,如血糖的水平,同时还允许病人能够有正常的活动。连续和/或自动地监测分析物的水平,可以在病人的分析物的水平处于或接近阈值时给病人发出警告。例如,如果分析物是血糖,则监测装置可配置成在发生或将要发生高血糖或低血糖的时候给病人发出警告。于是病人可以采取适当的措施。
发明内容
一般来讲,本发明涉及利用皮下埋植探测器以连续/或自动地在体内监测分析物水平的方法和装置。使用时,大多数这样的装置是小巧并便捷的,因此允许有很大的活动范围。一个实施方案是探测器控制单元,它具有适于放置在皮肤上的机壳。该机壳还适于接收电化学探测器的一部分。探测器控制单元包括导电触点,放置在机壳上,配置用来偶联探测器上的两个或多个接触垫。发送器放置在机壳内,并与多个导电触点连接用于发送使用探测器获得的数据。探测器控制单元也可包括多个任选元件,如,用于粘着到皮肤上的粘合剂,底座单元、接收器、处理电路、电源(例如电池)、警报系统、数据存储单元、监视器电路和测定电路。其它任选元件描述如下。
本发明的另一个实施方案是探测器组件,包括上述探测器控制单元。探测器组件还包括具有至少一个工作电极和至少一个连接到工作电极或电极的接触垫的探测器。探测器还包括任选的元件,如对电极、反/参考电极、参考电极、温度探针。下面描述其它元件和探测器的选择。
本发明的另一个实施方案是分析物监测系统,包括上述探测器控制单元。分析物监测系统还包括具有至少一个工作电极和至少一个连接到工作电极或电极的接触垫。该分析物监测系统还包括显示单元,它具有用于从探测器控制单元接收数据的接收器,和连接到接收器的显示器,用于显示分析物水平的读数。该显示单元还任选包括多个元件,如发送器、分析仪、数据存储单元、监视器电路、输入装置、电源、钟表、灯、寻呼机、电话接口、计算机接口、警报器或警报系统、收音机和校准器。显示器单元的其它元件和选项在后面描述。另外,分析物监测系统或分析物监测系统的元件可任选地包括能够确定药物或治疗方案和/或药物传送系统的处理器。
本发明另一个实施方案是用于将电化学探测器插入到病人体内的插入盒。该插入盒包括插入器。插入器的一部分具有尖锐、刚性、平面结构,适于在将电化学探测器插入时支持探测器。插入盒还包括具有配置用来接收电化学探测器和插入器的端口的插入枪,该插入枪具有用于驱动插入器和电化学探测器进入病人的驱动机构,和用于在将探测器留置在病人体内时取回插入器的回收机构。
另一个实施方案是使用电化学探测器的方法。将底座单元粘着在病人的皮肤上。插入枪对准底座单元的端口。电化学探测器放置在插入枪内,然后利用插入枪将电化学探测器插入到病人的皮肤内。取出插入枪,将探测器控制单元的机壳安装在底座上。放置在机壳上的多个导电触点连接到放置在电化学探测器上的接触垫,以准备探测器待用。
本发明的一个实施方案是用于检测植入的分析物-响应探测器失灵的方法。将分析物-响应探测器植入病人。分析物-响应探测器包括N工作电极和一个普通对电极,其中N是整数,并且是2或更大。然后获得在N工作电极之一和普通对电极产生的信号,并且如果来自普通对电极的信号在预定的阈值限度内不是来自工作电极之一的信号的N倍,则判断该探测器失灵。
另一个实施方案是校准具有一个或多个植入病人体内的工作电极的电化学探测器的方法。信号产生于每个工作电极。测试几种情况以判断校准是否适当。首先,来自一个或多个工作电极的每一个的信号的差应该小于第一阈值的量。第二,来自一个或多个工作电极的每一个的信号在预定范围内。第三,来自一个或多个动作电极的每一个的信号的变化率应该小于第二阈值量。确定分析病人体液的校准样本的校准值。然后,如果与上述条件吻合,则将校准值与来自一个或多个工作电极至少之一的信号相关联。
另一个实施方案是用于监测分析物水平的方法。将探测器插入到病人的皮肤内,并将探测器控制单元绑附到病人的皮肤上。将探测器控制单元上的两个或多个导电触点连接到探测器上的接触垫。然后,使用探测器控制单元,从由探测器产生的信号收集有关分析物水平的数据。收集的数据发送到显示器单元并在显示器单元上显示分析物水平的读数。
本发明上面的概述不打算描述本发明公开的实施方案或每一个实施例。附图和下面的描述将更具体地示例这些实施方案。
附图说明
在参考附图对本发明的各实施方案进行下面的详细描述后,本发明将会变得更加清楚。
图1是利用本发明的皮下植入的分析物探测器的皮下分析物监测器的一个实施方案的框图;
图2是根据本发明的分析物探测器的实施方案的顶视图;
图3A是图2的分析物探测器的截面图;
图3B是根据本发明的分析物探测器的另一个实施方案的截面图;
图4A是根据本发明的分析物探测器的第三实施方案的截面图;
图4B是根据本发明的分析物探测器的第四实施方案的截面图;
图5是图2的分析物探测器的尖端部分的放大顶视图;
图9是图2的分析物探测器的侧视图;
图10是另一种分析物探测器的顶视图;
图11是图10的分析物探测器的底视图;
图12是根据本发明的探测器和插入装置的实施方案的放大侧视图;
图13A、13B和13C是图12的插入装置的三个实施方案的截面图;
图14是根据本发明的皮肤上探测器控制单元的实施方案的截面图;
图15是图14的皮肤上探测器控制单元的底座的顶视图;
图16是图14的皮肤上探测器控制单元的盖的底视图;
图17是在病人的皮肤上的图14的皮肤上探测器控制单元的透视图;
图18A是根据本发明的皮肤上探测器控制单元的一个实施方案的框图;
图19A、19B、19C和19D是放置在根据本发明的皮肤上探测器控制单元的机壳的内表面的导电触点的四个实施方案的截面图;
图19E和19F是放置在根据本发明的皮肤上探测器控制单元的机壳的外表面的导电触点的两个实施方案的截面图;
图20A和20B是用于根据本发明的分析物监测装置内的电流-电压转换器的两个实施方案示意图;
图21是用于根据本发明的分析物监测装置的开口环路调节系统的一个实施方案的框图;
图22是根据本发明的接收器/显示器单元的实施方案的框图;
图23是接收器/显示器单元的一个实施方案的前视图;
图24是接收器/显示器单元的第二个实施方案的前视图;
图25是根据本发明的药物传送系统的一个实施方案的框图;
图26是根据本发明的插入枪的内部结构的透视图;
图27A是根据本发明的皮肤上探测器控制单元的一个实施方案的顶视图;
图27B是图27A的皮肤上探测器控制单元的底座单元的一个实施方案的顶视图;
图28A是在插入根据本发明的插入装置和探测器后,皮肤上探测器控制单元的一个实施方案的顶视图;
图28B是图28A的皮肤上探测器控制单元的底座单元的实施方案的顶视图;
图28C是图28A的皮肤上探测器控制单元的电子的至少一部分的机壳的实施方案的顶视图;
图28D是图28C的机壳的底视图;和
图28E是移去机壳盖的图28A的皮肤上探测器控制单元的顶视图;
图29描述了在不同温度下两种探测器电流-分析物水平曲线;
图30描述了三个码分多址(CDMA)发送器同时发送通过发送介质到CDMA接收器;
图31描绘了可以在交叉传送方案下传送的数据信息;
图32描绘了放置在基片上的发送器的一个可能的实施方案;
图33描绘了插入装置、探测器、插入枪和检测单元,它们可以组装并在插入盒中一起销售。
本发明可以进行各种修改和具有另外的形式,其具体形式通过下面伴随附图的详细描述来显示。然而,应该理解的是本发明并不限于这里描述的特别的实施方案。相反,本发明意在涵盖所有落在本发明所附的权利要求限定的精神和范围内的所有修改、等同物和替换物。
具体实施方式
本发明可用在分析物监测系统中,该系统使用可植入的探测器用于体内测定分析物,诸如体液中的葡萄糖或乳糖的浓度。探测器可以例如植入病人皮下以连续或定期监测病人间质液中的分析物。这可以指示病人血流中的血糖水平。根据本发明,也可以使用其它的体内分析物探测器,用于插入静脉、动脉或包含体液的体内其它部位。典型的分析物监测系统被配制成用于监测一段时间内的分析物水平,这段时间可以从几天到几周或更长的时间。
下面提供本文所用术语的定义:
“对电极”指的是与工作电极成对的电极,它通过与工作电极的电流幅值相等但信号相反的电流。在本发明的上下文中,术语“对电极”意思是指包括也用作参考电极的对电极(即,反/参考电极)。
“电化学探测器”是一种配置用来通过在探测器上的电化学氧化和还原反应来检测分析物的存在和/或测量其水平的装置。这些反应被转换成与样本中的分析物的量、浓度或水平相关的电信号。
“电解”是指直接在电极上或者经一个或多个电子转移剂发生的化合物的电氧化或电还原反应。
当化合物被捕获在或化学结合在表面上时,化合物被“固定”在表面上。
“不可浸出的”或“不可释放的”化合物或“不可浸出地沉积的”化合物意思是定义一种结合在探测器上使得它在探测器使用期间基本上不能从工作电极的工作表面上弥散开来的化合物(例如在探测器植入病人体内或测量样本期间)。
例如当成分共价地、离子地或协调地结合到探测器的成分上和/或捕获在聚合的或溶胶-凝胶基质或不能移动的膜上时,成分被“固定”在探测器内。
“电子转移剂”是可以直接或与其它电子转移剂一起携带分析物和工作电极之间的电子的化合物,电子转移剂的一个例子是氧化还原媒介。
“工作电极”是一种在有或没有电子转移剂作用下在其上进行分析物(或第二化合物,其水平依赖于分析物的水平)电氧化或电还原的电极。
“工作表面”是工作电极的一部分,它的上面涂敷有或可以有电子转移剂,配置用来暴露一种含分析物的液体。
“探测层”是探测器的组分,它包括促进分析物电解的成分。探测层可包括诸如电子转移剂、催化分析物反应以在电极上产生反应的催化剂或两者。在探测器的一些实施方式中,探测层是不可浸出地沉积在工作电极的近端或其上。
“不可腐蚀”导电材料包括非金属材料,诸如碳和导电聚合物。
分析物探测器系统
本发明的分析物监测系统可在各种条件下使用。用于该分析物监测系统中的探测器的特殊配置和其它元件可根据分析物监测系统计划的用途和分析物监测系统要操作的条件而定。分析物监测系统的一个实施方式包括配置用来植入到病人或用户体内的探测器。例如,探测器的植入可以在动脉或静脉系统中进行,用于直接测试血液中的分析物水平。或者,探测器可以被植入到间质组织中,用于测定间质液中的分析物水平。这种水平可以关联和/或转换成血液或其它液体中的分析物水平。植入的位置和深度可影响探测器的特殊形状、元件和配置。优选皮下植入,在一些情况下,限制探测器植入的深度。探测器可以植入到身体的其它区域以测定其它体液中的分析物水平。用于本发明的分析物监测系统中的适宜的探测器的例子公开在美国专利申请09/034372中,其全文并入这里用作参考。
图1以框图形式描述了使用可植入探测器42,特别是使用皮下可植入探测器的分析物监测系统40的一个实施方案。该分析物监测系统40最少包括探测器42和探测器控制单元44,其中所述探测器的一部分被构造成用来植入病人体内(例如皮下、静脉或动脉植入)。探测器42被连接到通常绑附在病人的皮肤上的探测器控制单元44。探测器控制单元44运行探测器42,这包括例如提供电压通过探测器42的电极并从探测器42收集信号。探测器控制单元44可评估来自探测器42的信号,和/或发送信号到一个或多个任选的接收器/显示器单元46、48用于进行评估。探测器控制单元44和/或接收器/显示器单元46、48可显示,或者传达分析物的电流水平。另外,当分析物的水平在或接近阈值水平时,探测器控制单元44和/或接收器/显示器单元46、48可通过例如可听、可看或其它感官刺激信号提示病人。在一些实施方案中,可以通过探测器的电极之一或任选的温度探针给病人传送一个电震作为警告。例如,如果检测葡萄糖,则可以用警报提示病人低血糖或高血糖水平和/或将要发生低血糖或高血糖。
探测器
如图2所示,探测器42包括至少一个形成在基片50上的工作电极58,探测器42还可以包括至少一个对电极(或对/参考电极)和/或至少一个参考电极62。对电极60和/或参考电极62可形成在基片50上,或者可以是分离的单元。例如,对电极和/或参考电极可以放置在同样植入病人体内的第二基片上,或对于一些可植入的探测器的实施方案,对电极和/或参考电极可以放置在病人的皮肤上,使工作电极或电极植入到病人体内。在美国专利5593852中公开了使用皮肤上对电极和/或参考电极和可植入体内的工作电极,其全文并入用作参考。
使用位于基片50上的导电道(traces)形成工作电极或电极58。对电极60和/或参考电极62以及探测器42的其它任选部分,如温度探针66也可以使用位于基片50上的导电道52来形成。这些导电道52也可以形成在基片50的光滑表面上,或在通道54内,它可以通过例如压印、刻痕或其它在基片50上产生凹陷。
探测层64(见图3A和3B)常常形成在至少工作电极58之一的近端或者其上,以利于分析物的电化学检测和样本液中其水平的测定,特别是在分析物不能以所需的速率和/或所需的特异性在裸极上电解的情况下。探测层64可包括电子转移剂以直接或间接地转移分析物和工作电极58之间的电子。探测层64还可包含催化剂以催化分析物的反应。探测层的元件可以在靠近或与工作电极58接触的液体或凝胶中。或者,探测层64的元件可以放置在接近或位于工作电极上的聚合的或溶胶-凝胶基质中。优选探测层64的元件不可浸出地位于探测器42内。更优选,探测器42的元件固定在探测器42内。
如下所述,除了电极58、60、62和探测层64以外,探测器42还包括温度探针66、质量传递限制层74(见图9)、可生物兼容层75(见图9),和/或其它任选元件。如下面将要的描述的,这些元件的每一种都增强了探测器42的功能和/或来自探测器42的结果。
基片
基片50可用多种非导电材料,包括例如聚合的或塑料材料和陶瓷材料构成。用于特定探测器42的适当材料可以至少一部分由所需的探测器42的用途和材料的特性来决定。
在一些实施方案中,基片是柔性的。例如,如果探测器42配置成用来植入到病人的身体内,则探测器42可以做成柔性的(尽管刚性探测器也可以做成可植入的探测器)以减少植入和/或佩带探测器42给病人带来的疼痛和对组织的损伤。柔性基片50经常增加病人的舒适度并允许病人有更大的活动范围。用于柔性基片50的适当材料包括例如非导电塑料或聚合的材料和其它非导电、柔性、可变形的材料。有用的塑料或聚合材料包括诸如聚碳酸酯、聚酯(例如MylarTM和聚对苯二甲酸二乙醇酯(PET))、聚氯乙烯(PVC)、聚氨酯、聚醚、聚酰胺或聚酰亚胺,或这些热塑性塑料,如PETG(乙二醇修饰的聚对苯二甲酸二乙醇酯)。
在其它实施方案中,探测器42使用相对刚性的基片50制造,例如,提供结构支持以抗弯曲或破裂。可用作基片50的刚性材料的例子包括导电性差的陶瓷,如氧化铝和二氧化硅。具有刚性基片的可植入性探测器42的一个优点是该探测器42可以有锐尖和/或锐缘,从而不需要另外的插入装置帮助探测器42插入。
值得注意的是,对于许多探测器42和探测器应用来说,不论刚性的还是柔性的探测器的操作都已足够。还可以控制探测器42的柔性并通过例如改变基片50的成分和/或厚度沿其长度改变柔性。
除了考虑柔性以外,经常需要可植入探测器42应当具有无毒性的基片50。优选基片50由一个或多个政府机构或私人团体批准体内使用。
探测器42可包括任选的特征,以便于如图12所示的可植入探测器42的插入。例如,探测器42可以在其尖端123呈点状,以利于插入。另外,探测器42可包括倒刺125,它能够帮助在操作探测器42时将探测器42固定在病人的组织内。然而,倒刺125要足够小,这样在从体内取出以更换探测器42时能够对皮下组织的损伤很小。
尽管在至少一些实施方案中,基片50沿探测器42全长具有统一的尺寸,在另一些实施方案中,基片50分别具有不同宽度53、55的远端67和近端65,如图2所示。在这些实施方式中,基片50的远端67可具有相对窄的宽度53。对于可植入到人体内皮下组织或其他部分的探测器42来说,基片50的远端67的狭窄宽度53可利于探测器42的植入。通常,探测器42的宽度越窄,在探测器植入期间和之后病人感觉的痛苦越少。
对于设计用来在病人正常的活动情况下连续或定期地监测分析物的可皮下植入的探测器42来说,将植入到病人体内的探测器42的远端67具有2毫米或更小的宽度53,优选1毫米或更小,更优选0.5毫米或更小的宽度。如果探测器42不具有不同的宽度区域,则探测器42将一般具有统一的宽度,例如2毫米、1毫米、0.5毫米、0.25毫米或更小。然而,也可以使用较宽或较窄的探测器。特别是,在用于插入静脉、动脉或病人的运动受限,例如病人被限制在床上或医院里的情况下,可使用较宽的可植入探测器。
再来看图2,探测器42的近端65可具有大于远端67的宽度55,以利于电极的接触垫49与控制单元上的触点的连接。探测器42在这一点上越宽,接触垫49就可以制作的越大。这会降低在适当地将探测器42与控制单元(例如图1的探测器控制单元44)上的触点连接所需的精度。然而,可限制探测器42的最大宽度,从而使探测器42保持较小,以利于病人的方便和舒适和/或适合分析物监测器的所需尺寸。例如,皮下可植入探测器42的近端65,如图1所示的探测器42可具有从0.5到15毫米范围,优选1毫米到10毫米,更优选3毫米到7毫米的宽度55。然而,在这个以及其他体内用途中较宽或较窄的探测器都可以使用。
基片50的厚度可以由基片材料的机械特性(例如材料的强度、模数和/或柔性)、探测器42的所需用途,包括由于使用而在基片50上产生的应力、以及任何通道或在基片上形成的凹痕来决定。典型地,在病人正常的活动情况下用于连续或定期地监测分析物水平的可皮下植入探测器42的基片50具有50到500微米,优选100到300微米的厚度。然而,也可以使用较厚和较薄的基片50,特别是在使用其它体内探测器42的情况下。
探测器42的长度依赖于多种因素,可以有较宽的值范围。影响可植入探测器42长度的因素可包括植入病人的深度和病人操纵小的柔性探测器42和连接探测器42与探测器控制单元44的能力。用于图1所示的分析物监测器的可皮下植入的探测器42可具有0.3到5厘米的长度范围。然而,也可以使用较长或较短的探测器。如果该探测器42具有较宽和较窄的部分,则探测器42的狭窄部分的长度(例如插入病人皮下的部分)一般在0.25到2厘米。然而,也可以使用较长和较短的部分。这个狭窄部分的全部或一部分可以植入到病人体内。其他可植入探测器42的长度至少一部分将根据探测器将要插入或植入的部分来决定。
导电道
在基片50上至少形成一个导电道52用于构建工作电极58。另外,在基片50上也可以形成其他导电道52用于形成电极(例如另外的工作电极、以及对电极、对/参考电极,和/或参考电极)和其他元件,如温度探针。导电道52可以沿探测器50的长度57的大部分长度延伸,如图2所示,尽管这不是必须的。导电道52的位置可根据分析物监测系统(例如控制单元触点和/或与探测器42关联的样本室的位置)的特别构造而定。对于可植入探测器,特别是皮下可植入探测器来说,导电道一般延伸接近探测器42的尖端以最小化必须植入的探测器的量。
导电道52可以通过各种技术,例如光蚀刻、丝网印刷或其他冲压或非冲压印刷技术在基片50上形成。导电道52也可以利用激光在有机(例如聚合的或塑料)基片50上形成碳化导电道52。在美国专利09/034422中描述了用于形成探测器42的示例性方法。
另一个用于在基片50上沉积导电道52的方法包括在基片50的一个或多个表面中的隐藏式通道54的形成,接着用导电材料56填充这些隐藏式通道54,如图3A所示。隐藏式通道54可以通过刻痕、压印或其他在基片50的表面上形成压痕的方法来形成。美国专利09/034422中描述了在基片50的表面形成通道和电极的示例性方法。通道的深度一般与基片50的厚度相关。在一个实施方式中,通道具有大约12.5到75微米(0.5到3mils),优选大约25到50微米(1到2mils)的深度范围。
一般使用导电材料56例如碳(例如石墨)、导电聚合物、金属或合金(例如金或金合金)或金属化合物(例如二氧化钌或二氧化钛)形成导电道。碳、导电聚合物、金属、合金或金属化合物的膜的形成是共知的,包括:如化学气相淀积(CVD)、物理气相淀积、溅射、反应溅射、印刷、涂布和涂漆。填充通道54的导电材料56常使用注入导电墨或导电糊等前体材料形成。在这些实施方案中,使用例如涂布、涂漆或应用铺展仪器如涂布刀的方法将导电材料56沉积在基片50的表面上。通道54之间的过量的导电材料则使用例如刀沿基片表面被除去。
在一个实施方案中,导电材料56是前体材料诸如导电墨的一部分,可以从例如Ercon有限公司(Wareham,MA)、Metech有限公司(Elverson,PA)、E.I.du Pont de Nemours和Co.(Wilminton,DE),Emaca-Remex Product(Montgomeryville,PA),或MCAServices(Melbourn,Great Britain)获得。一般导电墨以半液体或糊状应用,其中包含有碳、金属、合金或金属化合物和容积或分散体的颗粒。在将导电墨应用到基片50上(例如在通道54中)之后,溶剂或分散体蒸发,留下导电材料56的固体物质。
除了碳、金属、合金或金属化合物颗粒以外,导电墨还可以包含粘合剂。粘合剂可任选被固化以进一步粘合通道54内和/或基片50上的导电材料56。固化粘合剂增加导电材料56的导电性。然而,这一般是不需要的,因为由导电道52内的导电材料56携带的电流通常相对较低(通常低于1μA,并常常小于100nA)。典型的粘合剂通常包括例如聚氨酯树脂、纤维素衍生物、弹性体和高氟化聚合物。弹性体的实例包括硅酮、聚合二烯和丙烯腈-丁二烯-苯乙烯(ABS)树脂。氟化的聚合物粘合剂的实例是Teflon
Figure C0182278600161
(杜邦公司,Wilmington,DE)。这些粘合剂使用例如热和光,包括紫外光(UV)固化。适当的固化方法一般依赖于所使用的特定粘合剂。
当导电材料56的液体或半液体前体(例如导电墨)沉积在通道中时,该前体经常填充通道54。然而,当溶剂或分散体蒸发后,留下的导电材料56可能有体积损耗,使得导电材料56可以或不可以继续填充通道54。优选当导电材料体基损耗时,不从基片50中取出导电材料56而是降低通道54内的高度。这些导电材料56一般很好地粘合到基片50上,因此在溶剂或分散体蒸发期间不会从基片50中被拉出。其他合适的导电材料56要么粘合到基片的至少一部分上,和/或包含另外的添加剂,如粘合基,它将导电材料56粘合到基片50上。优选通道54中的导电材料56是不可浸出的,更优选其固定在基片50上。在一些实施方式中,导电材料56可通过多次应用分散的除去溶剂或分散体的液体或半液体前体来形成。
在另一个实施方式中,通道54通过使用激光来形成。激光碳化聚合物或塑料材料。以这种方法形成的碳用作导电材料56。另外的导电材料56,诸如导电碳墨可作为由激光形成的碳的补充。
在另一个实施方式中,导电道52由垫印刷技术形成。例如,可以使导电材料的膜形成为连续的膜或作为沉积在载体膜上的涂层。将此导电材料的膜放置在打印头和基片50之间。使用打印头根据导电道52的所需图案在基片50的表面上形成图案。通过压力和/或热从导电材料的膜上将导电材料转引到基片50上。这种技术经常在基片50上产生通道(例如由打印头产生的凹陷)。或者,不形成实质性的凹陷而在基片50的表面沉积导电材料。
在其他实施方式中,通过非冲击印刷技术形成导电道52。这种技术包括电子摄像术和磁变仪。在这些方法中,导电道52的图像电力地或磁力地形成在鼓上。激光或LED可用来电力形成图像。磁记录头可用来磁力形成图像。然后根据图像将调色剂材料(例如导电材料,诸如导电墨)吸引到鼓的部分。然后通过使鼓和基片接触而将调色基材料施加到基片上。例如,基片可以卷在鼓上。然后可以使调色剂材料变干和/或使调色剂材料中的粘合剂固化以将调色剂材料固着在基片上。
另一种非冲击印刷技术包括以所需图案将导电材料的小滴喷射到基片上。这种技术的实例包括喷墨打印和压电喷射打印。图案被送到打印机,然后打印机按照图案喷射导电材料(例如导电墨)。打印机可以提供连续的导电材料的流或者打印机可以在所需点以离散的量喷射导电材料。
还有另一个形成导电道的非冲击印刷实施方式包括离子谱法。在这种方法中,可固化的液体前体,如光可聚合丙烯酸树脂(例如获自Cubital,Bad Kreznach,德国的Solimer 7501)沉积在基片50的表面上。然后,具有导电道52的正或负图像的光掩膜被用来固化该液体前体。光(例如可见光或紫外光)根据光掩膜的图像被导向穿过光掩膜,以固化液体前体和在基片上形成固体层。除去未固化的液体前体,于是在固体层上留下通道54。然后可以用导电材料56填充该通道54以形成导电道52。
可以用上述方法形成宽度相对较窄的导电道52(和通道54,如果用的话),例如宽度为25到250微米范围,包括的宽度为例如250微米、150微米、100微米、75微米、50微米、25微米或更小。在基片50的同一侧具有两个或多个导电道52的实施方式中,导电道52间隔一段足以防止导电道52之间传导的距离。导电道52之间缘对缘的距离优选在25到250微米的范围,可以是例如150微米、100微米、75微米、50微米或更小。基片50上的导电道52的密度优选在大约150到700微米/道,可以小至667微米/道或更小,333微米/道或更小,甚至为167微米/道或更小。
工作电极58和对电极60(如果使用分离的参考电极)经常使用导电材料56,例如碳制成。适当的碳导电墨可获自Ercon有限公司(Wareham,MA),Metech有限公司(Elverson,PA),E.I.du Pontde Nemours和Co.(Wilmington,德国),Emca-Remex Products(Montgomeryville,PA),或MCA Services(Melbourn,英国)。典型地,工作电极58的工作表面51是导电道52的至少一部分,它与包含分析物的体液相接触(例如植入到病人体内)。
参考电极62和/或对/参考电极典型地由适合于参考电极材料的导电材料56,例如银/氯化银或不可浸出的结合到导电材料的氧化还原对,例如碳结合氧化还原对形成。适当的银/氯化银导电墨可获自Ercon有限公司(Wareham,MA),Metech有限公司(Elverson,PA),E.I.du Pont de Nemours和Co.(Wilmington,德国),Emca-Remex Products(Montgomeryville,PA),或MCA Services(Melbourn,英国)。银/氯化银电极显示了一种类型的参考电极,它包括金属电极与样本或体液的成分,在这种情况下是Cl-的反应。
适合的用于结合到参考电极的导电材料上的氧化还原对包括例如氧化还原聚合物(例如具有多个氧化还原中心的聚合物)。优选参考电极表面是非腐蚀性的,从而不会测量到错误电位。优选的导电材料包括较小腐蚀性金属,例如金和钯。最优选的是非腐蚀性材料,包括非金属性导体,诸如碳和导电聚合物。氧化还原聚合物可以吸附到或共价结合到参考电极的导电材料上,如导电道52的碳表面上。非聚合的氧化还原对也可以类似地结合到碳或金表面。
有很多方法可以用来将氧化还原聚合物固定到电极表面。一个方法是吸附固定。该方法对于具有相对较高的分子量的氧化还原聚合物特别有用。聚合物的分子量可以通过例如交联而增加。
另一个固定氧化还原聚合物的方法包括电极表面的官能化,然后使氧化还原聚合物化学结合,通常是共价结合到电极表面的官能团上。这种类型固定的一个实例从聚(4-乙烯基吡啶)开始。聚合物的吡啶环部分地与可还原/可氧化种类,如[Os(bpy)2Cl]+/2+络合,其中的bpy是2,2’-二吡啶。吡啶环的一部分通过与2-溴乙胺反应而季胺化。然后该聚合物例如使用二环氧化物,例如聚乙二醇二环氧甘油醚交联。
碳表面可以通过例如重氮盐的电还原进行修饰,以附着氧化还原种类或聚合物。如所描述的,在对氨基苯甲酸的重氮化作用下形成的重氮盐的还原用苯基羧酸官能团修饰碳表面。然后,这些官能团可以被碳二亚胺,如1-乙基-3-(3-二甲氨基丙基)碳二亚胺氢氯化物活化。然后活化的官能团与氨基-官能化的氧化还原对,如上面所述的季胺化的含锇氧化还原聚合物或2-氨基乙基二茂铁结合以形成氧化还原对。
类似地,金可以被胺例如胱胺官能化。如[Os(bpy)2(吡啶-4-羧酸酯)Cl]0/+的氧化还原对被1-乙基-3-(3-二甲氨基丙基)碳二亚胺氢氯化物活化以形成反应的O-acrylisourea,它与结合金的胺反应形成氨基化合物。
在一个实施方式中,除了使用导电道52作为电极或探条(probe lead)外,使用基片50上的两个或多个导电道52,以在例如分析物水平超过阈值时给病人一个温和的电刺激。该刺激可作为一个警告或警报以促使病人采取一些行动来恢复分析物到正常水平。
这个温和的电刺激通过在任何两个导电道52之间施加电压来产生,其中这两个导电道否则将不或被导电通路连接。例如,可使用电极58、60、62中的两个或电极58、60、62的一个和温度探针66以提供温和的电刺激。优选工作电极58和参考电极62不用做此目的,因为这可能会引起位于或靠近特定电极(例如工作电极上的探测层或参考电极上的氧化还原对)的化学成分的一些损失。
用于产生温和电刺激的电流一般在0.1到1mA。也可以使用高或低的电流,但需要考虑避免引起对病人的损伤。导电道之间的电压一般在1到10伏。然而,根据导电道52的电阻、导电道52之间的距离和所需的电流量,也可以使用较高或较低的电压。当传送温和的电刺激时,可以消除在工作电极58和穿过温度探针66上的电压,以防止由于在工作电极58(和/或温度探针66,如果使用的话)和提供温和电刺激的导电道52之间不希望的导电而引起的这些元件的损害。
接触垫
典型地,每个导电道52都包括接触垫49。接触垫49可以简单地是导电道52的一部分,除了接触垫49与控制单元(例如图1的探测器控制单元44)的导电触点相接触以外,与导电道52的其它部分没有区别。然而,更常见的是接触垫49是导电道52的一个区域,它比导电道的其余部分宽,以利于它与控制单元上的触点接触。通过使接触点49的宽度比导电道的其余部分相对较大,则对于在接触点49和控制单元上的触点的精确对准的要求不需要像较小的接触垫那样严格。
接触垫49一般使用与导电道52的导电材料相同的材料制成。然而,这不是必须的。尽管可以使用金属、合金和金属化合物形成接触垫49,但在一些实施方式中,也可以利用碳或其他非金属材料,例如导电聚合物制造接触垫49。如果接触垫49处于多雨的、潮湿或湿润的环境中,与金属或合金接触垫相比,碳和其他非金属接触垫不容易被腐蚀。在这些条件下,特别是当接触垫49和控制单元的触点是使用不同的金属或合金制成的情况下,金属和合金可能会腐蚀。
本发明的一个实施方案包括具有接触垫49的探测器42和具有导电触点(未显示)的控制单元44。在操作探测器42时,接触垫49和导电触点彼此接触。在一些实施方式中,接触垫49或导电触点都是使用非腐蚀性导电材料制成的。这种材料包括例如碳和导电聚合物。优选的非腐蚀性材料包括石墨和玻璃碳。相对的接触垫或导电触点是使用碳、导电聚合物、金属如金、钯或铂组金属或金属化合物,如二氧化钌制成的。这种接触垫和导电触点的结构减少了腐蚀。优选当探测器放置在3mMol,更优选在100mMol的NaCl溶液中时,由于接触垫和/或导电触点的腐蚀产生的信号少于探测器暴露于正常生理范围的分析物浓度时产生的信号的3%。因为至少对于一些皮下葡萄糖探测器,由正常生理范围内的分析物产生的电流为3到500nA。
如图10和11所示,电极58、60、62以及温度探针66(下面将要描述)的两个探条68、70连接到接触垫49。在一个实施方式中(未显示),接触垫49与接触垫49连接的各电极或温度探条一样位于基片50的同一侧。
在其他实施方式中,在至少一边的导电道52通过位于基片上的管道(vias)与位于基片50相对面的接触垫49连接,如图10和11所示。这种结构的一个优点是在控制单元上的触点和电极58、60、62和温度探针66的探条68、70每一个之间的接触可以在基片50的一侧完成。
在其他实施方案中(未显示),使用穿过基片的管道从而为导电道52提供基片50两侧的接触垫。可以通过在适当的位点形成穿过基片50的孔,然后用导电材料56填充该孔来形成连接导电道52和接触垫49a的管道。
示例性电极结构
下面描述许多示例性电极结构,然而,应该理解也可以使用其它结构。在一个实施方案中,如图3A所示,探测器42包括两个工作电极58a,58b和一个对电极60,它也用作参考电极。在另一个实施方案中,探测器包括一个工作电极58a,一个对电极60和一个参考电极62,如图3B所示。显示这些实施方案中的每一个都具有在基片50的同一侧形成的电极。
或者,可以在基片50的相对侧形成一个或多个电极。如果使用两种不同类型的导电材料56(例如碳和银/氯化银)形成电极,可能会很方便。然后,至少在一些实施方案中,仅需要一种类型的导电材料56应用到基片50的每一边,从而减少了制造过程中的步骤和/或使过程中对准的限制变得容易。例如,如果使用碳基导电材料56形成工作电极58,并使用银/氯化银导电材料56形成参考或对/参考电极,则为了制造方便,可以在基片50的相对面形成工作电极和参考或对/参考电极。
在另一个实施方案中,在基片50的一面形成两个工作电极58和一个对电极60,并在基片50的相对侧形成温度探针66。
探测层
一些分析物例如氧可以在工作电极58上直接电氧化或电还原。其他分析物,诸如葡萄糖和乳糖,需要至少一种电子转移剂和/或至少一种催化剂的存在,以利于分析物的电氧化或电还原。对于可以直接在工作电极58上电氧化或电还原的分析物,诸如氧可以使用催化剂。对于这些分析物,每个工作电极58具有形成在靠近或在工作电极58的工作表面上的探测层64。典型的,探测层64靠近或仅仅在工作电极58的一小部分,常常是靠近探测器42的尖端形成。这限制了形成探测器42所需要的材料的量,并将探测层64置于接触含分析物的液体(例如体液、样本液或载体液)的最佳位置。
探测层64包括一个或多个设计用来便于分析物电解的成分。探测层64可包括,例如用于催化分析物的反应并在工作电极58处产生响应的催化剂,用于间接或直接转移分析物和工作电极58之间或两者的电子的电子转移剂。
探测层64可以形成为所需成分(例如电子转移剂和/或催化剂)的固体组合物。这些成分优选是不会从探测器42浸出的,更优选固定在探测器42上。例如,可以将这些成分固定在工作电极58上。或者,探测层64的成分可以固定在工作电极58内,或者在一个或多个沉积到工作电极58上的膜(membranes)或薄膜(films)之间,或者这些成分可以固定在聚合的或溶胶-凝胶基质中。美国专利5262035、5264104、5264105、5320725、5593852和5666222,美国专利申请号08/540789和1998年2月11日提交的名称为“大豆过氧化物电化学探测器”的PCT专利申请号US98/02403,AttorneyDocket号M&G 12008.8WOI2中描述过固定的探测层的实例,将其全文并入这里作为参考。
在一些实施方案中,一个或多个探测层64的成分可以溶剂化、分散或悬浮在探测层64的液体中,而不是形成固体组合物。液体可以配置在探测器42中,或者可以被探测器42从含分析物的液体中吸附。优选溶剂化、分散或悬浮在这种类型的探测层64中的成分是不能从探测层浸出的。通过在探测层周围提供电池(例如电极、基片、膜和/或薄膜)以防止探测层64的成分浸出,可以实现非浸出性。这种电池的一个实例是微孔膜或薄膜,它允许分析物扩散进入到探测层64以与探测层64的成分接触,但是减少或消除探测层64外部的探测层成分(例如电子转移剂和/或催化剂)的扩散。
可以使用各种不同的探测层结构。在一个实施方式中,如图3A和3B所示,探测层64沉积到工作电极58a的导电材料56上。探测层64可以延伸超过工作电极58a的导电材料56。在这些情况下,探测层64可以延伸过对电极60或参考电极62,而没有降低葡萄糖探测器的性能。对于使用其中沉积有导电材料56的通道54的探测器42来说,如果导电材料56没有填充通道54,则探测层64的一部分可以形成在通道54内。
与工作电极58a直接接触的探测层64可包含用以直接或间接地转移分析物和工作电极之间的电子的电子转移剂,和利于分析物的反应的催化剂。例如,葡萄糖、乳糖或氧电极可以形成具有分别包含催化剂诸如葡萄糖氧化酶、乳糖氧化酶或漆酶和分别利于葡萄糖、乳糖或氧电氧化的电子转移剂的探测层。
在另一个实施方案中,探测层64没有直接沉积在工作电极58a上。而是探测层64与工作电极58a间隔一定距离,并且通过间隔层61与工作电极58a隔开,如图4A所示。这个间隔层61典型地包括一个或多个膜或薄膜。除了从探测层64隔离工作电极58a之外,间隔层61还可以用作质量转移限制层或干扰物消除层,这在下面会描述。
典型地,不直接与工作电极58a接触的探测层64包括利于分析物的反应的催化剂。然而,这个探测层64典型地不包括直接从工作电极58a转移电子到分析物的电子转移剂,因为探测层64与工作电极58a间隔开来。这种类型探测器的一个实例是葡萄糖探测器或乳糖探测器,它包括在探测层64中的酶(例如分别是葡萄糖氧化酶或乳糖氧化酶)。葡萄糖或乳糖与存在于酶中的第二种化合物(例如氧)反应。然后这个第二种化合物在电极处电氧化或电还原。电极处的信号的变化表明液体中第二种化合物的水平的变化,它与葡萄糖或乳糖的水平的变化成比例,因此,与分析物水平相关。
在另一个实施方案中,使用了两个探测层63、64,如图4B所示。两个探测层63、64的每一个都可以独立地形成在工作电极58a之上,或者在靠近工作电极58a的地方。尽管不是必须的,但一个探测层64典型地与工作电极58a间隔开来。例如,这个探测层64可包括催化分析物的反应以形成产品化合物的催化剂。然后该产品化合物在第二探测层63处电极,其中第二探测层63可包括转移工作电极58a和产品化合物之间的电子的电子转移剂和/或催化产品化合物的反应以在工作电极58a处产生信号的第二催化剂。
例如,葡萄糖或乳糖探测器可包括与工作电极间隔的第一探测层64,并包含酶例如葡萄糖氧化酶或乳糖氧化酶。在有适当的酶存在下,葡萄糖或乳糖的反应形成过氧化氢。第二探测层63直接形成在工作电极58a上,并包括过氧化物酶和电子转移剂,以响应过氧化氢而在电极处产生信号。然后可以将由探测器表示的过氧化氢的水平与葡萄糖或乳糖的水平相关。另一个操作类似的探测器可以使用具有葡萄糖或乳糖氧化酶两者的单一探测层形成,并且过氧化物酶沉积在单一探测层中。美国专利号5593852、美国专利申请号08/540789和1998年2月11日提交的名称为“大豆过氧化物电化学探测器”的PCT专利申请号US98/02403,Attorney Docket号M&G12008.8WOI2中描述过固定的探测层的实例,将其全文并入这里作为参考。
在一些实施方案中,一个或多个工作电极58b不具有相应的探测层64,如图3A和4A所示,或具有不含有一种或多种电解分析物所需的成分(例如电子转移剂或催化剂)的探测层(未显示)。在这个工作电极58b处产生的信号典型地从干扰物和其他源,例如液体中的离子而产生,而不是响应分析物(由于分析物没有电氧化或电还原)。因此,在这个工作电极58b处产生的信号对应于背景信号。例如可以通过从工作电极58a处得到的信号中减去从工作电极58b处得到的信号,而从另一个与完全探测层64相关的工作电极58a处得到的分析物信号中去除背景信号。
可以使用具有多个工作电极58a的探测器以通过平均在这些工作电极58a处产生的信号或测定结果而获得更精确的结果。另外,可以将在一个工作电极58a处获得的多个读数或在多个工作电极处获得的多个读数平均,以获得更精确的数据。
电子转移剂
在很多实施方案中,探测层64包含一个或多个与工作电极58的导电材料56相接触的电子转移剂,如图3A和3B所示。在本发明的一些实施方式中,在探测器42被植入到病人体内期间很少或没有电子转移剂从工作电极58中浸出。可扩散或可浸出(即可释放的)电子转移剂经常扩散到含分析物的液体中,从而通过随时间降低探测器的灵敏度而降低电极的效力。另外,电子转移剂从可植入的探测器42扩散或浸出也会伤害病人。在这些实施方式中,当将探测器浸入到含分析物的体液中24小时,优选72小时后,优选至少90%,更优选至少95%,最优选至少99%的电子转移剂保持沉积在探测器上。特别是对于可植入探测器而言,当将探测器进入到体液中37℃、24小时,更优选72小时后,优选至少90%,更优选至少95%,最优选至少99%的电子转移剂保持沉积在探测器上。
在本发明的一些实施方式中,为了防止浸出,将电子转移剂结合或固定在工作电极58,或一个或多个沉积在工作电极58上的膜或薄膜之间或之内。这些电子转移剂可以使用例如聚合的或溶胶-凝胶固定技术而固定在工作电极58上。或者,电子转移剂可以化学(例如离子地、共价地或配位地)结合到工作电极58上,这可以通过直接或间接地通过其他分子,诸如聚合物结合到工作电极58上,然后再与工作电极58结合。
如图3A和3B所示,工作电极58a上的探测层64的应用是产生工作电极58a的工作表面的一个方法。电子转移剂介导电子的转移以电氧化或电还原分析物并从而允许工作电极58和对电极60之间的电流流经分析物。电子转移剂的介导利于不适于直接在电极上进行电化学反应的分析物的电化学分析。
总之,优选的电子转移剂是具有氧化还原电位的可还原和可氧化的离子或分子,其中的氧化还原电位比标准的甘汞电极(SCE)的氧化还原电位高或低几百微伏。优选电子转移剂对SCE还原不超过大约-150mV和氧化不超过大约+400mV。
电子转移剂可以是有机的、有机金属的或无机的。有机氧化还原种类的实例是醌和在其氧化状态具有醌结构的种类,诸如尼罗蓝和靛酚。一些醌和部分氧化的氢醌与蛋白质的官能团,如半胱氨酸的硫醇基团、赖氨酸和精氨酸的胺基团和酪氨酸的酚基团反应,这使得这些氧化还原种类不适于本发明的一些探测器,这是因为在含分析物的液体中存在干扰蛋白。通常优选取代的醌和具有醌型化合物结构的分子,因为它们较少与蛋白质反应。优选的四取代的醌通常具有在1、2、3和4位上的碳原子。
总之,适用于本发明的电子转移剂具有防止或基本上减少在样本分析期间电子转移剂的扩散损失的结构或电荷。优选的电子转移剂包括氧化还原种类,其结合到聚合物上,而聚合物反过来又会固定到工作电极上。在氧化还原种类和聚合物之间的结合可以是共价的、配位的或离子的。有用的电子转移剂和产生它们的方法公开在美国专利号5264104、5356786、5262035和5320725中,其全文并入这里作为参考。尽管任何有机或有机金属氧化还原种类可以结合到聚合物上并用作电子转移剂,但优选的氧化还原种类是过渡金属化合物或络合物。优选的过渡金属化合物或络合物包括锇、钌、铁和钴化合物或络合物。最优选的是锇化合物或络合物。应该理解下面描述的许多氧化还原种类都可以使用,典型的没有聚合成分,因为在电子转移剂浸出的载体液或探测器的探测层中的电子转移剂是可接受的。
一种类型的不可释放的聚合的电子转移剂包括共价结合在聚合的组合物中的氧化还原种类。这种类型的介质的实例是聚(乙烯二茂铁)。
另一种类型的不可释放的电子转移剂包含离子结合的氧化还原种类。这种类型的介质典型地包括偶联到带相反电荷的氧化还原种类的带电的聚合物。这种类型的介质的实例包括偶联到阳性带电氧化还原种类,如锇或钌聚吡啶基阳离子的阴性带电聚合物,诸如Nafion
Figure C0182278600271
(杜邦)。另一个离子结合的介质的实例是偶联到阴性带电氧化还原种类,如铁氰化物或亚铁氰化物的阳性带电聚合物,如季胺化的聚(4-乙烯基吡啶)或聚(1-乙烯基咪唑)。优选的离子结合的氧化还原种类是结合到带相反电荷的氧化还原聚合物的高带电的氧化还原种类。
在本发明的另一个实施方案中,适当的不可释放的电子转移剂包括配位结合到聚合物的氧化还原种类。例如,通过锇或钴2,2’-二吡啶的配位作用络合到聚(1-乙烯基咪唑)或聚(4-乙烯基吡啶)可形成介质。
优选的电子转移剂是带有一个或多个配体的锇过渡金属络合物,每个配体具有含氮杂环,如2,2’-二吡啶、1,10-邻二氮杂菲或其衍生物。另外,优选的电子转移剂还具有一个或多个共价结合到聚合物内的配体,每个配体具有至少一个含氮杂环,如吡啶、咪唑或其衍生物。这些优选的电子转移剂迅速地在彼此和工作电极58之间交换电子,从而使得络合物可以迅速地氧化和还原。
一个特别有用的电子转移剂的实例包括(a)具有吡啶或咪唑官能团的聚合物或共聚物和(b)与两个配体络合的锇阳离子,每个配体包含2,2’-二吡啶、1,10-邻二氮杂菲或其衍生物,两个配体不一定是相同的。优选的用于与锇阳离子络合的2,2’-二吡啶的衍生物是4,4’-二甲基-2,2’-二吡啶和单、二和聚烷氧-2,2’-二吡啶,如4,4’-二甲氧基-2,2’-二吡啶。用于与锇阳离子络合的优选的1,10-邻二氮杂菲是4,7-二甲基-1,10-邻二氮杂菲和单、二和聚烷氧-1,10-邻二氮杂菲,如4,7-二甲氧基-1,10-邻二氮杂菲。用于与锇阳离子络合的优选的聚合物包括聚(乙烯基咪唑)(被称为“PVI”)和聚(4-乙烯基吡啶)(被称为“PVP”)。聚(乙烯基咪唑)的共聚物取代基包括丙烯腈、丙烯酰胺和取代的或季胺化的N-乙烯基咪做。最优选的是具有络合到聚(乙烯基咪唑)的聚合物或共聚物的锇的电子转移剂。
优选的电子转移基具有对标准甘汞电极(SCE)范围在-100mV到大约+150mV的氧化还原电位。优选电子转移剂的电位从-100mV到+150mV,更优选该电位在-50mV到+50mV。最优选的电子转移基具有锇氧化还原中心,和对SCE的从+50mV到-150mV的电位。
催化剂
探测层64还可以包括能够催化分析物的反应的催化剂。在一些实施方案中,催化剂还可以用作电子转移剂。适当的催化剂的一个实例是催化分析物反应的一个酶。例如,当分析物是葡萄糖时,可使用的催化剂,例如葡萄糖氧化酶、葡萄糖脱氢酶(例如吡咯并喹啉葡萄糖脱氢酶(PQQ))或寡糖脱氢酶。当分析物是乳糖时,可使用例如乳糖氧化酶或乳糖脱氢酶。当分析物是氧或在响应分析物的反应时产生或消耗氧的情况下可使用漆酶。
不论催化剂是探测器中固体探测层中的一部分还是探测层内液体中的溶剂化物,优选的催化剂是在置于探测器内时不可浸出的。更优选催化剂被固定在探测器内(例如在电极上和/或在膜或薄膜内或之间),以避免不希望的催化剂从工作电极58浸出并进入病人体内。例如,这可以通过将催化剂连接到聚合物、将催化剂与另一个电子转移剂(如上所述可以是聚合的)交联,和/或提供一个或多个上面具有比催化剂小的孔的隔膜或薄膜来实现。
如上所述,可以使用第二种催化剂。这个第二种催化剂经常被用来催化获自催化的分析物的反应的产品化合物的反应。第二种催化剂典型地以电子转移剂操作以电解产品化合物,在工作电极处产生信号。或者,可以在干扰物消除层提供第二种催化剂,以催化如下所述的去除干扰物的反应。
本发明的一个实施方式是一种电化学探测器,其中催化剂被混合或分散在形成工作电极58的导电道52的导电材料56中。例如,这可以通过将催化剂,例如酶混合在碳墨中和将混合物应用到基片50的表面上的通道54内来实现。优选将催化剂固定在通道53内,从而使它不会从工作电极58上浸出。例如,这可以通过使用适合于粘合剂的固化技术将粘合剂固化在碳墨中来实现。固化技术包括,例如溶剂或分散剂的蒸发、暴露于紫外光或暴露于热。混合物典型地在基本上不会降解催化剂的条件下施用。例如,催化剂可以是热敏感性酶。最好应该在没有持续的加热期间施用和固化酶和导电材料混合物。可以使用蒸发或UV固化技术或通过在短至不足以明显降解催化剂的时间内暴露加热来固化混合物。
另一个体内分析物探测器的考虑因素是催化剂的热稳定性。很多酶在生理温度下仅具有有限的稳定性。因此,需要使用大量的催化剂和/或使用在必须的温度下热稳定的催化剂(例如37℃或高于正常体温)。热稳定催化剂可以限定为当在37℃下保持至少1小时,优选至少一天,更优选至少三天时其活性下降小于5%的催化剂。热稳定性催化剂的一个实例是大豆过氧化物酶。当结合相同的或不同的具有葡萄糖或乳糖氧化酶或脱氢酶的探测层时,这个特定的热稳定性催化剂可用于葡萄糖或乳糖探测器。关于热稳定性催化剂和它们在电化学发明中的用途的进一步描述可参见美国专利5665222、美国专利申请号08/540789和1998年2月11日提交的名称为“大豆过氧化物电化学探测器”的PCT专利申请号US98/02403,Attorney Docket号M&G 12008.8WOI2。
分析物的电解
为了水解分析物,可将一个电压(对参考电压)施加到工作和对电极58、60。施加的电压的最小量值常依赖于特定的电子转移剂、分析物(如果分析物直接在电极处被电解)或第二种化合物(如果其水平依赖于分析物水平的第二种化合物如氧或过氧化氢,直接在电极处电解)。与直接在电极处电解的电子转移剂、分析物或第二种化合物的氧化还原电位相比,施加的电位通常与之相等或是更具氧化性或还原性,这依赖于所需的电化学反应。通常在工作电极处的电位要足够大,以驱动电化学反应完成或接近完成。
可任选限定电位的量值,以避免干扰物如尿酸盐、抗坏血酸盐和醋氨酚的明显的(通过响应分析物产生的电流来确定)电化学反应。如果这些干扰物以其他方法,例如通过配置如下所述的干扰物限制屏障已经除去,或包含一个可以获得背景信号的工作电极58b(参见图3A)可以避免这样的电位限制。
当电位施加到工作电极58和对电极60之间后,将会有电流流动。电流是分析物或第二种化合物电解的结果,它的水平受分析物的影响。在一个实施方案中,经电子转移剂和任选的催化剂发生电化学反应。在有适当的催化剂(例如酶)存在下,通过电子转移剂种类A氧化(或还原)许多分析物B以产生C。然后该电子转移剂A在电极处被氧化(或还原)。电子被电极收集(或除去),并测定所得的电流。这个方法可以用反应等式(1)和(2)来说明(可以写出在催化剂存在下分析物B被氧化还原介质A还原的类似等式):
如一个实施例中,电化学反应可基于在有葡萄糖氧化酶存在下葡萄碳的分子与两个不可浸出性铁氰化物阴离子的反应以产生两个不可浸出性亚铁氰化物阴离子、两个氢离子和葡糖酸内酯。通过电氧化不可浸出性亚铁氰化物阴离子成为不可浸出性铁氰化物阴离子并测定电流,可分析存在的葡萄糖的量。
在另一个实施方案中,其水平受分析物影响的第二种化合物在工作电极处被电解。在一些情况下为分析物D和第二种化合物,在这种情况下为反应体化合物E如氧,在有催化剂存在的条件下反应,反应等式(3)如下所示:
然后,反应体化合物E在工作电极处直接被氧化(或还原),如反应等式(4)所示:
或者,使用电子转移剂H(任选有催化剂的存在)间接氧化(或还原)反应体化合物E,它基本上在电极处还原或氧化,如反应等式(5)和(6)所示:
nH(ox)+E→nH(red)+I    (5)
在这两种情况下,由工作电极的信号指示的反应体化合物的浓度的变化与分析物的变化相反(即,随着分析物水平的增加,反应体化合物和电极处的信号的水平下降)。
在其他实施方案中,反应体第二种化合物是一个产品化合物F,如等式(3)所示。通过分析物D的催化的反应形成产品化合物F,然后在电极处直接电解或使用电子转移剂和任选的催化剂间接电解。在这些实施方式中,获自工作电极处的产品化合物F的直接或间接电解的信号直接对应于分析物的水平(除非还有其他产品化合物的源)。随着分析物的水平增加,在工作电极处的产品化合物和信号的水平也增加。
本领域技术人员会理解有很多不同反应可获得相同结果,即分析物或其水平依赖于分析物水平的化合物的电解。反应等式(1)到(6)显示了这些反应的非限制性实施例。
温度探针
探测器内可包括各种任选的项目。一个任选的项目是温度探针66(图11)。温度探针66可利用各种已知的设计和材料形成。一个示例性温度探针66是利用两个探条68、70形成的,其中所述探条68和70经由温度依赖性特性材料形成的温度依赖性元件72而彼此连接,适宜的温度依赖性特性的实例是温度依赖性元件72的阻抗。
两个探条68和70典型的是利用金属、合金、半金属如石墨、降解的或高掺杂的半导体,或小带隙半导体制成的。适合的材料的实例包括金、银、氧化钌、一氮化钛、二氧化钛、掺铟一氧化锡、掺锡一氧化铟或石墨。温度依赖性元件72典型地是利用与探条相同的导电材料,或具有温度依赖特性、如阻抗,其在电压源连接到温度探针66的两个探条68、70时可产生温度依赖性信号的诸如碳墨、碳纤维或铂的其他材料的精细的道(例如具有比探条68和70小的截面的导电道)形成。温度依赖性元件72的温度依赖性特性可随着温度增加或降低。优选温度依赖性元件72的特征性的温度依赖性在期望的生理温度范围内(大约25到45℃)随着温度呈大致线性的变化,尽管这不是必须的。
具有幅值或作为温度的函数的其他特性的信号(例如电流)典型地可通过在温度探针66的两个探条68和70之间提供电位来获得。随着温度变化,温度依赖性元件72的温度依赖特性相应于信号幅值的变化而增加或降低。来自温度探针66的信号(例如通过探针的电流的量)可以与获自工作电极58的信号合并,这是通过使温度探针信号成比例,然后从工作电极58处得到的信号中加或减去成比例的温度探针信号实现的。以这种方式,温度探针66可以对工作电极58的输出进行温度调节以弥补工作电极58的温度依赖性。
温度探针的一个实施方式包括探条68、70,形成为两个间隔的通道,其中具有形成为连接两个间隔的通道的横向通道的温度依赖性元件72。两个间隔的通道包含导电材料,诸如金属、合金、半金属、降解的半导体或金属化合物。横向通道可包含与探条68和70相同的材料(条件是横向通道具有小于两个间隔的通道的截面)。在其他实施方式中,横向通道中的材料不同于探条68和70的材料。
形成这种特殊温度探针的方法的一个实例包括形成两个间隔的通道,然后用金属或合金的导电材料填充它们。下一步,形成横向通道然后用所需的材料填充它。用两个间隔通道中每一个的导电材料覆盖横向通道中的材料,以形成电连接。
为了适当地操作温度探针66,温度探针66的温度依赖性元件72不能被形成在两个探条68和70之间的导电材料缩短。此外,为了避免由身体内或样本液内的离子种类在两个探条68和70之间形成导电,可以在温度依赖性元件72,优选在植入病人体内的探条68和70的一部分上配置一个盖。这个盖可以是例如放置在温度依赖性元件72和探条68和70上的非导电薄膜,用于防止离子导电。适当的非导电薄膜包括,例如KapronTM聚酰亚胺薄膜(杜邦,Wilmington,DE)。
另一个用于消除或减少体内或样本液中离子种类导电的方法是使用连接到探条68和70上的蓄电池电压(ac voltage)源。以这种方式,在每半个蓄电池电压的周期期间,正和负离子种类被交替吸引和排斥。这导致在体内或样本液中没有离子净吸引到温度探针66上。然后通过温度依赖性元件72的蓄电池电流的最大幅值可用来校正来自工作电极58的测量结果。
温度探针可以放置在与电极相同的基片上。或者,温度探针可以放置在另外的基片上。另外,温度探针可自己使用或与其他装置联合。
温度探针的另一个实施方式利用溶液(例如血液或间质液)的导电性的温度依赖性。假定电解质的浓度相对恒定,含电解质溶液的导电性典型地依赖于溶液的温度。血液、间质液和其他体液是具有相对恒定的电解质水平的溶液。因此,探测器42可包括两个或多个导电道导电道(未显示),由已知距离间隔。这些导电道的一部分暴露于溶液中并使用已知技术(例如应用恒定或已知电流或电位和分别测定所得电位或电流以确定导电性)来测定导电道暴露部分之间的导电性。
导电性的变化与温度的变化相关。可使用线性的、二次方程式、指数的或其他关系将该关系做成模型。用于该关系中的参数典型地在大多数人群中不发生明显改变。温度探针的标度可通过多个方法来确定,包括例如使用确定温度的独立方法(例如温度计、光或电温度检测器或如上所述的温度探针66)确定每个探测器42的标度,或校准一个探测器42和使用基于几何均一性的批量的用于所有其它探测器的标度。
生物相容性层
如图9所示,在皮下植入病人体内的探测器42的至少一部分上任选形成薄膜层75。这个任选的薄膜层。这个任选的薄膜层74可有一个或多个功能。薄膜层74防止大量生物分子穿透进入电极。这可以通过使用具有比要排除的生物分子小的孔径的薄膜层74来实现。这些生物分子会污染电极和/或探测层,从而降低探测器42的效力并改变用于给定分析物浓度的预定的信号幅值。工作电极58的污染会降低探测器42的使用寿命。生物相容性层74可防止蛋白质粘合到探测器42上、血块形成和其他不希望的在探测器42和身体之间的相互作用。
例如,可以用生物相容性涂层涂敷探测器外部的全部或一部分。优选的生物相容性涂层是当与包含分析物的液体均衡后包含至少20wt%液体的水凝胶。美国专利号5593852中描述了适宜的水凝胶的实例,它还包括交联的聚环氧化物,如聚环氧乙烷四丙烯酸酯,其全文并入这里作为参考。
干扰物消除层
探测器42中可以包括一干扰物消除层(未显示)。干扰物消除层可以并入到生物相容性层75中或在质量转移限制层74(下面将要描述)中,或者可以作为一单独的层。干扰物是在电极处直接或经电子转移剂电还原或电氧化以产生错误信号的分子或其他种类。在一个实施方式中,薄膜或膜防止一种或多种干扰物穿透进入工作电极58周围的区域。优选这种类型的干扰物消除层对于一种或多种干扰物的透过率远远小于对分析物的透过率。
干扰物消除层可包括离子成分,如Nafion,掺入到聚合的基质中以减少干扰物消除层对带有与离子成分相同的电荷的离子干扰物的透过率。例如,可以将带负电荷的化合物或形成负离子的化合物掺入到干扰物消除层中以减少身体或样本液中负电种类的渗透。
干扰物消除层的另一个实例包括用于催化去除干扰物的反应的催化剂。这种催化剂的一个实例是过氧化物酶。过氧化氢与诸如醋氨酚、尿酸盐和抗坏血酸盐一类的干扰物反应。可以将过氧化氢加入到含分析物的液体中,或者可以通过例如在葡萄糖氧化酶或乳糖氧化酶存在的条件下,由葡萄糖或乳糖的反应分别在原位产生。干扰物消除层的实例包括交联的过氧化物酶:(a)使用戊二醛(gluteraldehyde)作为交联剂或(b)在过氧化物酶甘油酶中的寡糖基团与NaIO4的氧化,之后通过使形成的醛与聚丙烯酰胺基质中的酰肼基团偶联来形成腙,这公开于美国专利号5262305和5356786中,其全文并入这里做参考。
质量转移限制层
在探测器中可包括质量转移限制层74,用作扩散限制屏障,以减少分析物,例如葡萄糖或乳糖转移到工作电极58附近区域的质量转移率。通过限制分析物的扩散,可减少工作电极58附近的分析物的浓度的稳态浓度(这与身体或样本液中分析物的浓度成正比)。这扩展了仍然可以准确地测定的分析物浓度的上限范围,和也扩展了其中电流随分析物水平大致线性地增加的范围。
优选分析物通过薄膜层74的渗透率随温度变化的很小或完全没有变化,从而减少或消除电流随温度的改变。为了这个原因,优选从25℃到45℃的生理相关温度范围内,更重要的是在30℃到40℃的范围内,薄膜上的孔径或它的水合作用或膨胀都不发生过度变化。优选质量转移限制层是由在24小时内吸收少于5%的液体的薄膜制成。这可以减少或避免对温度探针的需要。对于可植入探测器来说,优选质量转移限制层是使用在37℃、超过24小时吸收少于5wt%的液体的薄膜制成。
用于薄膜层74的特别有用的材料是在探测器试验中在含分析物的液体中不肿胀的膜。适宜的膜包括3到20000nm直径的孔。优选具有5到500nm直径、界限明确、孔径均一和高纵横比的孔的膜。在一个实施方式中,孔的纵横比优选为2或更大并更优选为5或更大。
利用放射性核素发射的加速电子、离子或质粒,通过径迹蚀刻聚合的膜可制造界限分明并均一的孔。最优选的是各向异性的、聚合的、径迹蚀刻的膜,加热条件下,它在垂直于孔的方向的扩展小于在孔的方向的扩展。适宜的聚合物膜包括聚碳酸酯膜,获自Poretics(Livermore,CA,分类号19401,0.01微米孔径聚碳酸酯膜)和CorningCostar Corp.(Cambridge,MA,NucleoporeTM品牌,0.015微米孔径的膜)。也可以使用其它的聚烯烃和聚酯膜。优选当质量转移限制膜在皮下组织液中滞留期间,该膜的渗透性在30℃到40℃的范围内时,每℃的变化不超过4%,优选不超过3%,更优选不超过2%。
在本发明的一些实施方案中,质量转移限制层74也可以限制氧流入探测层42。这可以在氧的部分压力变化引起探测器呈非线性反应的情况下使用探测器42时改善探测器42的稳定性。在这些实施方案中,与膜限制分析物的转移相比,质量转移限制层74限制氧的转移至少40%,优选至少60%,更优选至少80%。对于给定类型的聚合物来说,优选具有较大密度(例如接近于晶体状聚合物的密度)的膜。聚酯,诸如聚乙烯对苯二酸酯典型地对氧具有较小的渗透性,因此比聚碳酸酯膜优选。
抗凝结剂
可植入的探测器可任选在植入病人体内的基片的部分放置有抗凝结剂。抗凝结剂可以减少或消除探测器周围的血液或其他体液的凝结,特别是在探测器插入后。血凝块会污染探测器或不可逆地减少分析物扩散到探测器中的量。有用的抗凝结剂的实例包括肝素和组织血纤维蛋白溶酶原激活物(TPA),以及其他已知的抗凝结剂。
抗凝结剂可以应用到至少探测器的准备植入的那一部分上。可以通过例如浸泡、喷雾、刷涂或浸渍的方法应用抗凝结剂。使抗凝结剂在探测器42上干燥。可以使抗凝结剂固定在探测器的表面或可以使它扩散到探测器的表面。典型地沉积到探测器的抗凝结剂的量远远低于用在治疗涉及血凝结等医学症状的情况下所使用的量,因此只具有有限的局部化的作用。
探测器寿命
探测器42可以被设计成在体内分析物监测器,特别是可植入的分析物监测器中可更换的元件。典型地,探测器42可以运行许多天。优选运行时间至少为一天,更优选至少为三天,最优选至少为一周。然后可以去除探测器42并用新的探测器替换。电极的污染或电子转移剂或催化剂浸出会缩短探测器42的寿命。通过分别使用如上所述的生物相容性层75或不可浸出的电子转移剂和催化剂,可以克服探测器42的使用寿命问题。
另一个对探测器42的寿命的主要限制是催化剂的温度稳定性。很多催化剂是酶,它们对环境温度非常敏感,并且在病人的体温(例如对于人体来说大约是37℃)下会降解。因此,如果可以的话应该使用稳健的酶。当足量的酶已经被灭活而出现不可接受次数的测量误差时应该更换探测器42。
插入装置
如图12所示,可以使用一插入装置120,以将探测器42插入到病人皮下。该插入装置120典型地使用刚性材料,如金属或刚性塑料形成。优选的材料包括不锈钢和ABS(丙烯腈-丁二烯-苯乙烯)塑料。在一些实施方案中,插入装置120在其尖端121处被弄尖和/或弄锐以利于刺入病人的皮肤。锐、薄的插入装置会减少在插入探测器42的时候给病人带来的疼痛的感觉。在另一些实施方案中,插入装置120的尖端121具有其他形状,包括钝或平的形状。这些实施方式在探测器42不插入皮肤而是作为探测器42推入皮肤时的探测器42的支持结构时特别有用。
插入装置120可具有各种截面形状,如图13A,13B和13C所示。图13A所示的插入装置120是平的,可绑附或连接到探测器42上的平面的、弄尖的刚性材料带,以利于将探测器42插入病人皮肤,或者在插入期间为探测器42提供支持结构。图13B和13C的插入装置是U或V形的植入物,它支持探测器42以限制在插入期间探测器42弯曲或弓起的量。示于图13B和13C的插入装置120的截面宽度124典型地为1毫米或更小,优选为700微米或更小,更优选500微米或更小,最优选300微米或更小。示于图13B和13C的插入装置120的截面高度典型地是大约1毫米或更小,优选大约700微米或更小,更优选大约500微米或更小。
探测器42本身可包括利于插入的任选特征。例如,探测器42可以被弄尖以利于插入,如图12所示。另外,探测器42可包括帮助探测器42留在病人的皮下组织的倒刺125。倒刺125还可以在操作探测器42时帮助探测器42固定在病人的皮下组织内。然而,典型的倒刺125是足够小以在更换探测器42时从病人体内取出时对病人的皮下组织的损害较小。探测器42还可以包括用于与插入装置中的相应结构(未显示)配合的槽口,以在插入时对探测器42施加压力,而在取出插入装置120时可以松解。插入装置中的这种结构的一个实例是在插入装置120的两个相对侧之间有一个棒(未显示),并且具有插入装置120的适宜高度。
操作时,探测器42放置在插入装置120的内部或接近插入装置120,然后向插入装置120和/或探测器42施加一个力以使探测器42插入病人皮肤。在一个实施方案中,将力施加到探测器42以将探测器42推入皮肤,而插入装置120保持固定并给探测器42提供结构支持。或者,将力施加到插入装置120和任选地施加到探测器42以将探测器42和插入装置120的各自一部分都穿透病人皮肤并进入皮下组织。插入装置120任选地被从皮肤和皮下组织中拉出,而将探测器42借助探测器42和病人组织之间的摩擦力保留在皮下组织内。如果探测器42还任选包括一个倒刺125,则由于倒刺能够卡在组织中,所以这种结构可以促使将探测器42保留在间质组织中。
施加到插入装置120和/或探测器42的力可以通过手动或机械施加。优选探测器42可重复性地插入病人皮肤。在一个实施方式中,使用插入枪将探测器插入。图26显示了用于插入探测器42插入的插入枪200的实例。插入枪200包括外罩202和载体204。插入装置120典型地安装在载体204上并且探测器42预先装载在插入装置120内。例如,通过使用在插入枪200内的竖起的或卷起的弹簧、压缩空气的爆发、由第二磁铁推动的电磁石等,载体204驱动探测器42并且任选地驱动插入装置120进入病人的皮肤。在这种情况下,例如,当使用弹簧时,载体204和插入装置可以移动、竖起或准备导向病人的皮肤。
在插入探测器42后,插入枪200可包括将插入装置120拔出病人皮肤的机构。这种机构可使用弹簧、电磁石等以取出插入装置120。
插入枪可反复利用。插入装置120通常是一次性的以避免可能的污染。或者,插入装置120可以经灭菌后重复使用。另外,可以用抗凝结剂涂敷插入装置120和/或探测器42以避免探测器42污染。
在一个实施方式中,探测器42被注射到病人的间质组织中2到12毫米用于皮下植入。优选探测器被注射到间质组织中3到9毫米,更优选5到7毫米。本发明的其他实施方式可包括植入到病人的其他部分,例如动脉、静脉或器官的探测器。植入的深度根据要植入的靶位而变。
尽管探测器42可以插入到身体的任何地方,但经常需要定位插入位点,使得皮肤上探测器控制单元44可以取消。另外,经常需要插入位点是身体里神经末梢密度较低的地方,以减少病人的疼痛。用于插入探测器42和定位皮肤上探测器控制单元44的优选位点的实例包括腹部、股部、腿部、上臂和肩膀。
测量从皮肤平面的插入角度(即,垂直于皮肤插入探测器应该为90°的插入角度)。插入角度通常在10到90°、典型地在15到60°、更经常在30到45°的范围内。
皮肤上探测器控制单元
皮肤上探测器控制单元44被配置成可放置在病人的皮肤上。可任选将皮肤上探测器控制单元44制成使病人舒适的形状,它可允许隐藏在例如病人的衣服下面。股部、腿部、肩膀或腹部是用于放置皮肤上控制单元44以保持隐藏的病人身体上比较方便的部位。然而,皮肤上探测器控制单元44也可以放置在病人身体的其他部位。皮肤上探测器控制单元44的一个实施方式具有薄、卵圆形形状,以便于隐藏,如图14-16所示。然而,也可以使用其它形状和尺寸。
如下所述,皮肤上探测器控制单元44的高度、宽度、长度、重量和体积可以改变,并至少一部分依赖于包括在皮肤上探测器控制单元11内的元件和相关功能。例如,在一些实施方式中,皮肤上探测器控制单元44具有1.3厘米或更小、优选0.7厘米或更小的高度。在一些实施方式中,皮肤上探测器控制单元44具有的重量为90克或更小、优选45克或更小、更优选25克或更小。在一些实施方式中,皮肤上探测器控制单元44具有的体积为大约15立方厘米或更小、优选大约10立方厘米或更小、更优选大约5立方厘米或更小、最优选大约2.5立方厘米或更小。
皮肤上探测器控制单元44包括外罩45,如图14-16所示。外罩45典型地形成为一个单一整合的单元,放置在病人的皮肤上。外罩45典型地包括皮肤上探测器控制单元44的大部分或全部的电子元件,如下所述。皮肤上探测器控制单元通常不包括连接到其他电子元件或其他装置的附加的电缆或电线。如果外罩包括两或多个部件,则这些部件典型地彼此相配以形成单一的整体单元。
可以使用多种材料,包括例如塑料和聚合材料,特别是刚性热塑和工程热塑材料制造如图14-16所示的皮肤上探测器控制单元的外罩45。适当的材料包括例如聚氯乙烯、聚乙烯、聚丙烯、聚苯乙烯、ABS聚合物和它们的共聚物。可采用各种技术,包括例如喷射模塑法、压缩模塑法、浇铸和其他成型方法形成皮肤上探测器控制单元44。在皮肤上探测器控制单元44的外罩45上可形成空心或凹陷区域。如下面要描述的皮肤上探测器控制单元44的电子元件和/或其他物件,如电池或用于发出警报的扬声器可以放置在空心或凹陷区域。
在一些实施方式中,在外罩45的内部,例如空心或凹陷区域可提供导电触点80。
在一些实施方式中,电子元件和/或其他物件在模制塑料或聚合材料或其他成型过程中并入皮肤上探测器控制单元44的外罩45中。在另一些实施方式中,电子元件和/或其他物件在模制材料冷却过程中或在模制材料已经重新加热以使它柔韧的过程中并入外罩45中。或者,可使用扣件,如螺栓、螺母和螺钉、钉子、长钉、铆钉等或粘合剂,如接触粘合剂、压敏粘合剂、胶水、环氧化物(epoxies)或粘合剂树脂等将电子元件和/或其他物件固定在外罩45中。在一些情况下,电子元件和/或其他物件完全没有固定在外罩45上。
在一些实施方式中,皮肤上探测器控制单元44的外罩45是一个单件。导电触点80可以形成在外罩45的外部,或者在外罩45的内部,前提是外罩45中有端口78,通过该端口,探测器42可以导向接近导电触点80。
在其他实施方式中,皮肤上探测器控制单元44的外罩45被形成为至少两个分离的部分,例如基座74和盖76,它么彼此相配形成外罩45,如图14-16所示。外罩45的两个或多个部分可以完全彼此分开。或者,外罩45的两个或多个部分中的至少一些可以例如通过铰链彼此连接,以利于这些部分联合从而形成皮肤上探测器控制单元44的外罩45。
这些皮肤上探测器控制单元44的外罩45的两个或多个分离的部分可以具有互补、互锁的结构,如互锁脊或在一个元件上是脊而在另一个元件上是互补的槽,使得两个或多个分离的元件可以很容易和/或牢固地结合在一起。这可能会在一些情况下,特别是当例如更换电池或探测器42时,需要将元件拆分又装配在一起的情况下特别有用。然而,也可以使用其它扣件以将两个或多个元件连接在一起,包括例如螺栓、螺母和螺钉、钉子、长钉、长钉、铆钉等。另外,可以使用的永久性或临时性粘合剂可包括例如接触粘合剂、压敏粘合剂、胶水、环氧化物或粘合剂树脂等。
外罩45典型地至少是防水的以避免液体流入而与外罩中的元件包括例如导电触点80接触。优选外罩是耐水的。在一些实施方式中,外罩45的两个或多个元件,例如基座74和盖76紧密地配合在一起以形成密封的、防水的或耐水密封,从而液体不能流入到皮肤上的探测器控制单元44的内部。这对于避免皮肤上探测器控制单元44内的物件,如导电触点、电池或电子元件的腐蚀流和/或降解,特别是在病人进行诸如淋浴、洗澡或游泳这样的活动时非常有用。
这里所用的耐水指的是在密封条件下当浸入到水中1米深度时没有水通过耐水密封或外罩。这里所用的防水意思是在密封条件下,当浸入到水中10米,优选15米时没有水穿透防水密封或外罩。经常需要皮肤上探测器控制单元的电路、电源(例如电池)和导电触点以及探测器的导电触垫被包含在耐水,优选防水的环境中。
除了外罩45的部分,如基座74和盖76以外,还可以有皮肤上探测器控制单元44的其他单独形成的件,它们可以在制造过程中或之后组装。这种单独形成件的一个实例是用于安装在基座74或盖76上的凹陷中的电子元件的盖。另一个实例是用于配置在基座74或盖76中的电池的盖。这些皮肤上探测器控制单元44的单独形成件可永久性地固定在基座74、盖76或皮肤上探测器控制单元44的其他元件上,例如用于电子元件的盖、或可移动地固定,如用于电池上的可移动的盖。用于固定这些单独形成件的方法包括使用扣件,如螺栓、螺母和螺钉、钉子、长钉、铆钉等,摩擦性扣件,如舌和槽结构,或粘合剂,如接触粘合剂、压敏粘合剂、胶水、环氧化物或粘合剂树脂等。
皮肤上探测器控制单元44的一个实施方式是由用于操作该单元的电池完成的一次性单元。单元上没有哪一部分是需要病人打开或取出的,因此减小了单元的尺寸并简化了它的结构。在使用前皮肤上探测器控制单元44任选保持在休眠状态,以保存电池的能源。皮肤上探测器控制单元检测其正在被使用并激活自身。使用的检测可通过许多机构。这些包括例如通过电子触点的电阻的变化的检测、当皮肤上探测器控制单元44与安装单元(mounting unit)77匹配时开关的启动(见图27A和28A)。当在阈值限度内不再运行时,例如,如果电池或其它电源不再产生足够的能量时,通常需要更换皮肤上探测器控制单元44。通常这种皮肤上探测器控制单元44在外罩45的外部具有导电触点80。一旦探测器42被植入病人体内,探测器控制单元44被放置在探测器42之上,使导电触点80与探测器42上的接触垫49相接触。
如图17所示,皮肤上探测器控制单元44典型地绑附在病人的皮肤75上。可通过各种技术固定,包括例如利用粘合剂将皮肤上探测器控制单元44直接粘合到病人的皮肤75上,粘合剂提供在皮肤上探测器控制单元44的外罩45的至少一部分上,而皮肤上探测器控制单元44通过皮肤上探测器控制单元44上的缝合口(未显示)而缝合到皮肤75上,或者通过捆扎将皮肤上探测器控制单元44固定在皮肤上。
另一个将皮肤上探测器控制单元44的外壳45连接到皮肤75上的方法包括使用座架单元77。该座架单元77通常是皮肤上探测器控制单元44的一部分。适合的座架单元77的一个实例是双侧粘合带,其一侧粘合到病人的皮肤表面,另一侧粘合到皮肤上探测器控制单元44上。在这个实施方式中,座架单元77可具有任选的开口79,该开口要足够大以允许探测器42穿过该开口79。或者,探测器可插入通过薄的粘合剂并进入皮肤。前述每一种用于将皮肤上探测器控制单元44保持在相对于皮肤75固定的定向关系中的技术都可以用于本发明的实施方式中,其中发送器98被放置在基片50上。例如,基片50本身可粘着到皮肤75上,可缝合到皮肤上或者可利用前述技术和材料捆扎在皮肤75上。
各种粘合剂,包括例如压敏粘合剂(PSA)或接触粘合剂可用于将皮肤上探测器控制单元44直接或使用座架单元77粘合到病人的皮肤75上。优选那种在至少将特定探测器42植入到病人体内期间对所有或大多数病人没有刺激的粘合剂。或者,可以在座架单元中包括第二粘合剂或其他皮肤保护化合物,从而对于其皮肤被座架单元77上的粘合剂激惹的病人来说,可以用第二粘合剂或其他皮肤保护化合物覆盖其皮肤,然后将座架单元77放置在第二粘合剂或其他皮肤保护化合物上。由于座架单元77上的粘合剂不再与皮肤接触,而是与第二粘合剂或其他皮肤保护化合物接触,所以应该基本上能避免病人皮肤的激惹。
本发明的另一个实施方式允许将发送器98放置在探测器基片50上。在该实施方式中,发送器98电连接到位于基片50上的至少一个导电道上,从而给发送器98提供一个代表体液中的分析物水平的信号。这种设置提供了减轻分析物监测装置的用户将发送器98电连接到探测器42的困难的优势。这是一个优势,因为涉及前述电连接的机构对于用户来说可能完成起来较困难。另外,如果用户将探测器42连接到发送器,则应该设计电连接机构免遭潮湿和污染,这使得外罩45对于装置的操作来说变得更加重要。
图32描绘了放置在基片260上的发送器263的一个可能的实施方案。如从图32可看到的,基片260上有一个导电道268,其一部分经化学处理形成电化学探测器。基片260可以是柔性的,以使病人舒适。这种柔性可以减少在遭受冲击时基片260破碎,并在用户的体内埋入基片的碎片的风险。因此,柔性增强了用户的安全性。发送器263由集成电路264组成,这种集成电路设计用来产生代表体液中分析物的水平的发送信号。在一个实施方式中,集成电路264包括:(1)以一定间隔发送代表体液中分析物水平的数据的组织电路;(2)用从组织电路发送的数据调节载波信号的调节器;和(3)放大调节的载波信号的放大器。尽管图32描绘了单一集成电路264,但本领域技术人员会理解通过连接到模拟集成电路的数字集成电路可体现集成电路264。集成电路264由放置在基片260上的电池262供能。集成电路264电连接到导电道268,从而给集成电路264提供代表体液中分析物水平的信号。集成电路264的输出是一个传输信号,它被提供给天线266,该天线266用于传输信号到天线266周围空间的区域。天线266可以采取几种形式。在一个实施方式中,天线266直接印刷到基片260上。在另一个实施方式中,天线266可以采取放置在基片260上的分离结构的形式,如安装在基片260上的线圈的形式。另外,不管天线266是以分离结构的形式还是以印刷到基片260上的形式体现,天线266可以从发送器263定位到基片260的反面。
重要的是发送器263要避免腐蚀或污染的影响。为此,在一个实施方式中,发送器263被包封在保护性的非导电涂层,如环氧化物里。
使用其中发送器263被放置在基片260上的前述实施方案的病人,可通过简单地将探测器的可植入部分透皮插入并固定该单元于皮肤上来使用该装置。探测器不需要由病人连接到皮肤上探测器控制单元(如图17所示的皮肤上探测器控制单元44)。因此,整个装置变成一次性的,这意味着装置的用户能够购买该装置作为单一单元并且在例如使用一天到十四天或更长的时间后抛弃。
存在图32中描绘的本发明的其他实施方式。例如,尽管显示电池262被安装在基片260上,但电池262可作为与单一单元发送器263/基片260分立的单元。在这种实施方式中,设计发送器263与电池相匹配,从而为发送器263提供电源。因此,发送器263/基片260组合在使用一段时间后可以抛弃,而电池262可以重复与多个分离的发送器263/基片260组合使用,直到其能量消耗尽。如果电池262呈现为一种分立单元,则可以将电池置于一种分立的腔内,这种腔设计用来稳定和保护电池免遭冲击、污染和腐蚀。这种腔允许电池262与发送器263匹配,与发送器263/基片260组合的几何结构相一致并维持最小的外形。
返回来看图17,当探测器42变换时,例如可以将皮肤上探测器控制单元44移动到病人的皮肤75的不同位置,以避免过度激惹。或者,可以将皮肤上探测器控制单元44保留在病人的皮肤上的相同位置直到确定单元44应该移动时为止。
图27A和27B显示了用于皮肤上探测器控制单元44的座架单元77的另一个实施方式。如图27A所示,座架单元77和皮肤上探测器控制单元44的外罩45可以以例如互锁的方式安装在一起。座架单元77是由例如塑料或聚合物材料,包括例如聚氯乙烯、聚乙烯、聚丙烯、聚苯乙烯、ABS聚合物和它们的共聚物形成。座架单元77可以使用各种技术,包括例如喷射模塑法、压缩模塑法、浇铸和其他成型方法形成。
座架单元77典型地包括在座架单元77的底表面上的粘合剂,以粘合到病人的皮肤,或者座架单元77被用来例如与双面胶带等结合。座架单元77典型地包括开口79,探测器42可通过其插入,如图27B所示。座架单元77也可以包括用于将探测器42固定在位置上并紧贴皮肤上探测器控制单元42上的导电触点的支持结构220。座架单元77还任选包括一定位结构222,如从座架单元77的材料的延伸,它对应于一个结构(未显示),如探测器42上的开口,以利于通过例如将两个互补结构对齐而适当地定位探测器42。
在另一个实施方式中,结合的座架77和皮肤上探测器控制单元44的外罩45被提供在粘合片204上,带有任选的盖206以保护和/或限制皮肤上探测器控制单元44的外罩45,如图28A所示。任选的盖可包含粘合剂或其他机构用于附着到外罩45和/或座架单元77上。座架单元77典型地包括开口49,通过它可放置探测器42,如图28B所示。开口49可任选被配制成允许利用插入装置120或插入枪200(见图26)通过开口49插入探测器42。皮肤上探测器控制单元44的外罩45具有基座74和盖76,如图28C所示,外罩45的底部外观如图28D所示,有一个端口230,导电道(未显示)通过它延伸以与探测器42上的接触垫相连接。如图28E所示,用于连接电路元件的配电盘232可任选被配置在皮肤上探测器控制单元44内。
在一些实施方式中,皮肤上探测器控制单元44上的粘合剂和/或座架单元77的任何实施方式都是耐水或防水的,以允许病人在其皮肤75上粘合有皮肤上探测器控制单元44的情况下能够进行诸如淋浴和/或洗澡这样的活动,在至少一些实施方式中,能避免水穿透进入探测器控制单元44。结合有耐水或防水外罩45的耐水或防水粘合剂的使用能保护探测器控制单元44内的元件和导电道80与探测器42之间的导电触点免遭损害或腐蚀。排水的非激惹性粘合剂的一个实例是Tegaderm(3M,St.Paul,MN)。
在一个实施方式中,皮肤上探测器控制单元44包括一个探测器端口78,探测器42通过该端口进入病人的皮下组织,如图14和16所示。探测器42可通过探测器端口78插入到病人的皮下组织中。然后皮肤上探测器控制单元44可以放置在病人的皮肤上,而使探测器42穿过探测器端口78。如果探测器42的外罩45具有例如基座74和盖76,则盖76可以移动以允许病人将探测器42放置在适当的位置,从而与导电触点80接触。
或者,如果导电触点80在外罩45的内部,则病人可以滑动探测器42进入到护套45直到在接触垫49和导电触点80之间形成接触。探测器控制单元44可具有一个结构,该结构在探测器42位于使接触垫49与导电触点80相接触的适当位置时可阻挡探测器42进一步向护套的滑动。
在其他实施方式中,导电触点80位于护套45的外部(见图27A-27B和28A-28E)。在这些实施方式中,病人导引探测器42的导电垫49以与导电触点80相接触。在一些情况下,可以在护套45上配置导引结构,它导引探测器42进入适当的位置。这种结构的一个实例包括从护套45延伸的一组导轨,并具有探测器42的形状。
在一些实施方式中,当使用插入装置120(见图12)将探测器42插入后,插入装置120或任选的插入枪200(见图26)的尖端在所需的插入位点被定位于贴紧皮肤或座架77的位置。在一些实施方式中,没有任何导引而将插入装置120定位在皮肤上。在另一些实施方式中,插入装置120或插入枪200使用座架单元77中的导引装置(未显示)或皮肤上探测器控制单元44的其他部分被定位。在一些实施方式中,座架单元77中的导引装置、开口79和/或皮肤上探测器控制单元44的护套45中的探测器端口78具有与插入装置120和/或插入枪200的尖端的形状互补的形状,以相对于开口79和/或探测器端口78限制插入装置120和/或插入枪200的方向。然后通过使开口79或探测器端口78与插入装置129和/或插入枪200的互补形状相配合可以将探测器皮下插入到病人体内。
在一些实施方式中,设计导引装置、开口79或探测器端口78和(b)插入装置120或插入枪200的形状使两个形状可以仅仅在单一方向上匹配。这使得在每次将新的探测器插入病人时有助于以相同方向插入探测器。这种在插入方向上的一致性在一些实施方式中是需要的,以确保探测器42上的接触垫49能准确地与皮肤上探测器控制单元44上的适宜的导电触点80对齐。另外,如上所述,插入枪的使用可确保探测器42以统一、可再现性的深度插入。
如图14-16所示,探测器42和皮肤上探测器控制单元44内的电子元件经导电触点80连接。一个或多个工作电极58、对电极60(或对/参考电极)、任选的参考电极62和任选的温度探针66连接到各个导电触点80上。在图14-16显示的实施方式中,导电触点80配置在皮肤上探测器控制单元44的内部。皮肤上探测器控制单元44的其他实施方式具有位于护套45外的导电触点。导电触点80的位置是这样的,当探测器42恰当地定位在皮肤上探测器控制单元44内时,导电触点80与探测器42上的接触垫49相接触。
在图14-16显示的实施方式中,皮肤上探测器控制单元44的基座74和盖76是这样形成的,当探测器42在皮肤上探测器控制单元44的内部,并且基座74和盖76互相啮合,探测器42弯曲。以这种方式,探测器42上的接触垫49与皮肤上探测器控制单元44上的导电触点80相接触。皮肤上探测器控制单元44可任选包括支持结构82,以在正确方向上固定、支持和/或导引探测器42。
图19A-19D显示了适宜的导电触点80的非限制性实施例。在一个实施方式中,如图19A所示,导电触点80是针84等,当皮肤上探测器控制单元44的元件,例如基座74和盖76啮合在一起时,针84与探测器42上的接触垫49相接触。在探测器42的下方可配置一个支架82,以促进探测器42上的接触垫49与针84之间充分接触。针典型的是由导电材料诸如金属或合金,例如铜、不锈钢或银制成。每个针具有从皮肤上探测器控制单元44延伸的远端,用于与探测器42上的接触垫49接触。每个针84还具有连接到电线或其他导电带的近端,而电线或其他导电带又连接到皮肤上探测器控制单元44内的电子元件的剩余部分(例如图18A和18B所示的电压电源95和测量电路96)。或者,针84可以直接连接到剩余电子元件。
在另一个实施方式中,如图19B所示,导电触点80形成为一串具有散布的绝缘区域90的导电区域88。导电区域88可以与探测器42上的接触垫49一样大或者比它大,以减少对准关系。然而,绝缘区域90应该足够宽,使得导电区域88不会覆盖两个接触垫49,而接触垫49的确定是根据预计的探测器42的位置变化和接触垫49相对于导电触点80而确定的。导电区域88是使用诸如金属、合金或导电碳一类材料形成的。绝缘区域90可以使用已知的绝缘材料,包括例如绝缘塑料或聚合物材料形成。
在另一个实施方式中,在探测器42上的接触垫49和植入到或形成在皮肤上探测器控制单元44中的导电触点80之间可使用单方向导电粘合剂92,如图19C所示。
还有另一个实施方式,导电触点80是从皮肤上探测器控制单元44的表面延伸的导电膜94,用以接触接触垫49,如图19D所示。这些膜可使用各种不同形状,然而,它们彼此应该电绝缘。导电膜94可使用金属、合金、导电碳或导电塑料和聚合物构成。
任何上述示例性的导电触点80可以从皮肤上探测器控制单元44的内部的上表面延伸,如图19A-19C所示;或者从皮肤上探测器控制单元44的内部的下表面延伸,如图19D所示;或者,特别是在探测器42具有在探测器的两个面上的接触垫49的情况下,从皮肤上探测器控制单元44的内部的上和下两个表面延伸。
护套45外部上的导电触点80也可以具有如图19E和19F所示的各种形状。例如,导电触点80可嵌入护套45中(图19E)或从护套45延伸(图19F)。
导电触点80优选由不会因为与探测器42的接触垫49接触而发生腐蚀的材料制成。腐蚀可发生在两种不同的金属相接触的情况下。因此,如果接触垫49由碳构成,则优选的导电触点80可以由任何材料,包括金属或合金构成。然而,如果任何接触垫49都是由金属或合金构成,则优选与金属的接触垫连接的导电触点80是由非金属导电材料,如导电碳或导电聚合物构成,或者导电触点80和接触垫49由非金属材料,如单向性导电粘合剂分开。
在一个实施方式中,在探测器42和皮肤上探测器控制单元44之间的导电触点被省略。电力经感应耦合,例如使用探测器和皮肤上探测器控制单元上的闭路空间天线(例如面层线圈)(未显示)被传导到探测器。探测器控制单元44的电特性的变化诱发天线附近的磁场的变化。磁场的变化在探测器的天线中诱发电流。探测器和皮肤上探测器控制单元的密切接近导致适度的有效电力传输。在探测器中的感应电流可用于电力稳压器、运行的放大器、电容器、集成电路、发送器、和构成探测器结构的其他电子元件。使用例如经相同或不同天线的感应连接和/或经探测器上的发送器的信号的传送,数据被传送回探测器控制单元。感应偶联的使用可消除探测器和皮肤上探测器控制单元之间的电接触。这种接触常常是噪声和失灵的根源。还有,可以将探测器控制单元整个密封,这样可以增加皮肤上探测器控制单元的防水性能。
可以以下述方式制备和使用皮肤上探测器控制单元的一个实例。在其底部具有粘合剂的座架单元77被应用到皮肤上。贴着座架单元77定位携带有探测器42和插入装置120的插入枪200(见图26)。任选地设计插入枪200和座架单元77使它们只有在一个位置上才能恰当地配合。激活插入枪200,探测器42的一部分和任选的插入装置120的一部分被驱动进入皮肤,例如皮下组织。插入枪200抽回插入装置200,使插入皮肤的探测器42的那一部分留下。然后将皮肤上探测器控制单元44的护套45连接到座架单元77。任选地形成护套45和座架单元77使它们仅仅在一个位置上才能恰当地配合。护套45和座架单元77的配合在探测器42上的接触垫49(见图2)和皮肤上探测器控制单元44的导电触点80之间建立接触。任选地这种作用激活皮肤上探测器控制单元44开始运行。
插入装置、探测器、插入枪、和座架单元可以作为一个单元制造、上市或销售。例如,图33描绘了插入装置270、探测器272、插入枪274和座架单元276,它们可以组装(如箭头所示)在插入盒里一起销售。在这样的插入盒的实施方案中,可以以预载入的形式包装插入枪274,使插入装置270和探测器272配合或连接,配合的探测器272和插入装置270装载在插入枪的载体278上,而座架单元276已经与插入枪274的末端配合。
在一个实施方式中,将插入枪274包装成准备插入探测器272(也许是插入装置270)进入皮下组织的状态。例如,可以将插入枪274包装成“准备击发状态”,使得用于将探测器272插入皮下组织的插入力作为势能储存在装置中(在图33描述的实施方式的情况下,通过压缩其弹簧,使势能储存在弹簧的线圈中可以将插入枪274做成“准备击发状态”)。优选以这种方式包装的插入枪274使用一种“保险装置”,一种防止其储存的势能释放的屏障。除去屏障以允许势能释放。在图33呈现的实施方式的上下文中,保险装置是一个针(未显示),一旦压缩,它阻止弹簧弹出。因此,可以在购买使获得这种样子的插入盒,除去其包装,除去其保险装置后不需要另外的步骤就可以使用。或者,可以以上述预负载结构,但不要“准备击发状态”包装插入枪274。因此,在购买时可获得“非准备击发状态”的插入枪274的插入盒,除去其包装、准备击发状态并使用。为了利于以最少的用户操作来使用插入盒,可以在包装前使插入盒灭菌。可接受的灭菌技术的实例包括将插入和暴露在伽吗辐射或e射束下。
皮肤上探测器控制单元电子元件
皮肤上探测器控制单元44典型地还包括至少运行探测器42和分析物监测装置系统40的一部分电子元件。皮肤上探测器控制单元44的电子元件的一个实施方式以框图形式显示在图18A。皮肤上探测器控制单元44的电子元件典型地包括用于运行皮肤上探测器控制单元44和探测器42的电源95、用于从探测器42获得信号并运行探测器42的探测器电路97、将探测器信号转换成所需的格式的测量电路96和以最小量从探测器电路97和/或测量电路96获得信号,并将信号提供给任选的发送器98。在一些实施方式中,处理电路109可以部分或全部地评估来自探测器42的信号并将所得数据传输到任选的发送器98和/或如果分析物水平超过阈值则激活任选的警报系统94。处理电路109通常包括数字逻辑电路。
皮肤上探测器控制单元44可任选包括发送器98,用于发送探测器信号或从处理电路109发送处理的数据到接收器/显示器单元46、48;用于暂时或永久存储来自处理电路109的数据的数据存储单元102;用于从温度探针66接收信号和运行该温度探针66的温度探针电路99;用于提供参考电压,以与探测器产生的信号相比较的参考电压发生器101;和监视皮肤上探测器控制单元44中的电子元件的运行的监视器电路103。
还有,探测器控制单元44通常包括利用半导体装置,如晶体管的数字和/或模拟元件。为了运行这些半导体体装置,皮肤上探测器控制单元44可包括其他元件,例如包括加偏压于模拟和数字半导体装置的偏压控制发生器105、提供时钟信号的振荡器107、为电路的数字元件提供定时信号和逻辑运算的数字逻辑和定时元件。
作为这些元件的运行的一个实例,探测器电路97和任选的温度探针电路99提供来自探测器42的新的信号到测量电路96。测量电路96使用例如电流-电压转换器、电流-电频转换器和/或二进位计数器或其他产生与新信号的绝对值成比例的信号的指示器将该新的信号转换成所需格式。这可以用于例如将新信号转换成可用于数字逻辑电路的格式。然后该处理电路109可任选评估数据和提供命令以运行这些电子元件。
在皮肤上探测器控制单元44的另一个实例中,它也包括任选的元件如用于接收例如校准数据的接收器99、用于保存例如厂内设置的校准数据、经接收器99获得的校准数据和/或从例如接收器/显示器单元46、48或其他外部装置接收的运行信号的校准数据存储单元100、用于警告病人的报警系统104、用于关闭报警系统的解除开关111。
使用软件程序、硬件元件或它们的组合可执行分析物监测系统40和探测器控制单元44的功能。使用各种技术包括,例如集成电路或离散电子元件可运行硬件元件。集成电路的应用典型地减小了电子元件的大小,这可获得较小的皮肤上探测器控制单元44。
使用电源95运行皮肤上探测器控制单元44和探测器42的电子元件。适当的电源95的实例是一个电池,例如,如用于很多手表、助听器和其它小电子装置中的薄电路电池。优选电池具有至少30天、更优选具有至少三个月、最优选具有至少一年的使用寿命。电池通常是皮肤上探测器控制单元44中最大的元件之一,所以常需要减小电池的大小。例如优选电池厚度为0.5毫米或更小、优选.035毫米或更小,最优选0.2毫米或更小。尽管可使用多个电池,但优选仅使用一个电池。
探测器电路97经探测器控制单元44的导电触点80连接到一个或多个探测器42、42’。探测器的每一个最少代表工作电极58、对电极60(或对/参考电极)和任选的参考电极62。当使用两个或多个探测器42、42’时,探测器典型地具有单个工作电极58,但是可以共享对电极60、对/参考电极和/或参考电极52。
探测器电路97从探测器42或探测器42、42’接收信号并运行它们。探测器电路97可使用电流计、电量分析、电位测定法、电压测定法和/或其它电化学技术从探测器42获得信号。这里示例了探测器电路97,使用安培计从探测器42获得信号。然而,应该理解的是探测器电路还可以适当地配置成其他结构以使用其它电化学技术获得信号。为了获得安培计测量结果,探测器电路97典型地包括给探测器42提供恒定电位的稳压器。在其他实施方式中,探测器电路97包括给探测器42提供恒定电流并可用于获得电量或电位测量结果的稳流器。
来自探测器42的信号一般具有至少一个特征,如随着分析物的浓度变化的电流、电压或电频。例如,如果探测器电路97使用安培计操作,则信号电流随着分析物浓度而变化。测量电流96可包括将信号的携带信息的部分从一种特征转换成另一种的电路。这种转换的目的可以提供例如更易传输的、更易被数字电路读取的信号,和/或具有较少的受噪声的影响。
图20A提供了标准的电流-电压转换器的一个实例。在该转换器中,来自探测器42的信号在放大器130(运算放大器)的一个输入端口134被提供,并连接通过电阻器138到输出端136。然而,这种特定的电流-电压转化器131可能难以在小的CMOS码片中执行,因为电阻器经常难以在集成电路上执行。典型地使用离散的电阻器元件。然而,使用离散的元件增加了在电路中所需要的空间。
图20B显示了另一个电流-电压转换器141。这种转换器包括运算放大器140,其具有来自探测器42的在输入端144提供的信号和在输入端142提供的参考电位。在输入端144和输出端146之间放置一个电容器145。另外,提供开关147a,147b,149a和149b以允许电容器以时钟(CLK)频率确定的速率充电和放电。在操作中,在半个周期期间,开关147a和147b关闭而开关149a和149b打开,以允许电容器145由于连接的电位V1而充电。在另半个周期期间,开关147a和147b打开而开关149a和149b关闭,以停止充电(ground)或允许电容器145部分或全部放电。电容器145的反应性阻抗类似于电阻器138的阻抗(见图20A),这允许电容器145仿效电阻器。“电阻器”的值依赖于电容器145的电容和时钟频率。通过改变时钟频率,电容的反应性阻抗(“阻抗值”)改变。通过改变时钟频率可以改变电容145的阻抗的值(“电阻”)。使用例如晶体管可以在CMOS码片中运行开关147a,147b,149a和149b。
在测量电路96中还可以使用电流-电频转换器。一个适当的电流-电频转换器包括使用来自探测器42的信号给电容器充电。当通过电容器的电位超过阈值时,允许电容器放电。因此,来自探测器42的电流越大,达到阈值电位越快。这导致一个信号通过电容器,它具有改变的特征,对应于电容器的充电和放电,具有随着探测器42的电流增加而增加的电频。
在一些实施方式中,分析物监测系统40包括分布在一个或多个探测器42上的两个或多个工作电极58。这些工作电极58可用于质量控制的目的。例如,可以比较使用这两个或多个工作电极58输出的信号和/或衍生的分析的数据,以确定来自工作电极的信号是否在所需的容受水平以内。如果输出信号不满足此条件,则警告病人需要更换一个探测器或一些探测器。在一些实施方式中,只有在两个探测器之间缺乏协调持续预定时间后才警告病人。在每一次测量或间隔规定时间可进行两个信号的比较。或者或另外,可以由病人或其他人主动进行比较。再者,可使用来自两个探测器的信号以产生在比较后可以丢弃的数据或一个信号。
或者,例如,如果两个工作电极58具有同一个对电极60,并且分析物的浓度通过安培计测量,如果工作电极运行适当的话,在预定的容受水平内,则对电极60上的电流应该是在每个工作电极上的电流的两倍。如果不是这样的话,则如上所述需要更换一个或一些探测器。
使用来自仅仅一个工作电极的信号用于质量控制的实例包括将利用单个工作电极获得的连续的读数进行比较,以确定它们的差异是否超过阈值。如果该差异大于一个读数或一段时间的阈值或一段时间内预定数目的读数的阈值,则警告病人需要更换探测器42。典型地确定连续的读数和/或阈值,使得所有的预计的探测器信号的偏移都在所需的参数之内(即探测器控制单元44不认为分析物浓度的真正改变是探测器失灵)。
探测器控制单元44可任选包括温度探针电路99。温度探针电路99提供恒定电流(或恒定电位)通过温度探针66。所得电位(或电流)根据温度依赖元件72的电阻改变。可用作温度依赖元件的装置的实例包括整流器二极管和双极结晶体管。整流器二极管的阈值随着二极管温度的增加而降低。因此,经由逐步增加穿过pn结的电位,通过测定正向电压可确定温度,其中所述正向电压是允许给定水平的正向电流穿过pn结所需的。类似地,已知双极结晶体管的正向增益随着温度而增加。因此,通过向双极结晶体管加偏压从而在已知的校准温度下产生已知的集电器电流可确定温度。集电器电流的变异可以与已知的校准温度和实际温度之间的差异相关。
可以将温度探针66配置呈可放置在皮肤的表面(从而使温度依赖元件66紧密靠近,或优选邻接皮肤表面)。这种配置的益处是这种温度探针不需要植入,从而使得基片50的可植入部分保持较小的尺寸,这对于植入的便利和减少疼痛来说非常有利。以这种配置,可测定皮肤表面温度,与探测器化学点处的温度相对。如后面将要描述的,可以使用补偿因子以根据在皮肤表面测定的温度确定在探测器化学点处的温度。
来自探测器电路97和任选的温度探针电路的输出被连接到测量电路96,测量电路96获得来自探测器电路97和任选的温度探针电路99的信号,并且至少在一些实施方式中,以可以例如被数字电路读取的格式提供输出数据。来自测量电路96的信号被送到处理电路96,它接着又提供数据到任选的发送器98。处理电路109可具有一个或多个下列功能:1)将来自测量电路96的信号传送到发送器98;2)将来自测量电路96的信号传送到数据存储电路102;3)例如,利用电流-电压转换器、电流-电频转换器或电压-电流转换器将信号的携带信息特征从一个特征转换成另一个特征(例如当还没有被测量电路96做过的情况下);4)利用校准数据和/或来自温度探针电路99的输出修饰来自探测器电路97的信号;5)确定间质液中分析物的水平;6)根据获自间质液中的探测器信号确定血流中的分析物水平;7)确定是否分析物的水平、变化率和/或变化率的加速度超过或满足一个或多个阈值;8)如果满足或超过阈值则启动警报;9)根据一系列探测器信号评估分析物水平的趋势;10)确定药物的剂量;和11)例如通过平均或比较来自多个工作电极58的读数的信号减少噪声和/或误差。
如图29所描绘的,探测器电流(或为此目的的任何其他探测器特征)直接随着分析物水平改变。因此,在给定温度特定的探测器电流-分析物水平曲线描绘了探测器电流和分析物水平之间的关系。例如,在给定温度下,T1为探测器电流-分析物水平曲线,P1代表它们之间的关系。如图29所描绘的,曲线P1具有斜率S1。经常已知特定曲线以可预知的方式随着温度的变化而变。例如,对于温度从T1每升高1℃,斜率S1以特定的量(对于每升高1℃温度或许增加6%的陡度)变得越陡。图29通过第二个电流-分析物水平曲线P2描绘了这种原则,P2描绘了探测器电流和分析物水平之间在第二温度T2时的关系。由于T2大于T1,因此斜率S2大于S1。在本发明的一些实施方式中,处理电路109被设计用来解释这种关系,当探测的温度随着给定温度变化时,其通过使用来自测量电路96的温度信息以已知方式来调节给定温度下的已知曲线。例如,在一个实施方式中,处理电路109包括微处理器或应用特殊集成电路(ASIC),它们设计用来根据+/-6%斜率/-1℃温度变化的关系来调节已知曲线的斜率较大或较小。或者,可以在接收器/显示器装置256的处理电路中进行这种计算。如上所述,如果将温度探针66定位在皮肤表面,可以调节温度信息以估计在探测器化学点处的温度。通过线性关系可以将皮肤表面温度与探测器化学点处的温度相关。例如,在一个实施方式中,配置和安排处理电路109以通过假设在皮肤表面的温度的5℃变化对应于皮肤下特定深度处的温度的n℃变化(n可以是凭经验确定的值),来计算在探测器化学电处的温度的估计值。因此,以在皮肤表面的温度的常识和探测器植入深度处的温度的常识,可以获得探测器化学点处的温度的值。类似地,可以在接收器/显示器装置256的处理电路中进行探测器化学点处的温度的估计。
处理电路109可以是简单的并执行仅仅一个或少数几个这些功能,或者处理电路109可以很复杂并执行全部或大多数这些功能。皮肤上探测器控制电路44的大小可随着处理电路执行的功能的数目和这些功能的复杂性而增加。在皮肤上探测器控制单元44中大多数这些功能不是由处理电路109执行的,而是由接收器/显示器单元46、48中的其他分析器152执行的(见图22)。
测量电路96和/或处理电路109的一个实施方式提供在工作电极58和对电极60之间流过的电流作为输出数据。测量电路96和/或处理电路109还可以提供来自表明探测器42的温度的任选的温度探针66的信号作为输出数据。来自温度探针66的信号可以简单地作为通过温度探针66的电流,或者处理电路109可包括从获自测量电路96的信号确定温度探针66的阻抗,以与探测器42的温度相关的装置。然后可以将输出数据送到发送器98,它发送该数据到接收器/显示器装置46、48中至少其一。
再来看处理电路109,在一些实施方式中,处理电路109较复杂,它能够确定分析物的浓度或代表分析物浓度的一些测量,如电流或电压值。处理电路109可以结合温度探针的信号从而在获自工作电极58的信号或分析的数据中进行温度校正。这可包括例如缩放温度探针测量结果和从获自工作电极58的信号和分析的数据中将缩放的测量结果加上或减去。处理电路109还可以结合下面将要描述的已经从外源接收的或者已经结合到处理电路109的校准数据,以校正获自工作电极58的信号或分析的数据。另外,处理电路109可包括用于将间质中分析物水平转换成血液中分析物水平的校正算法。在Schmidtke等的”注射胰岛素后大鼠血液和皮下糖浓度之间一过性差异的测量和模型”,美国国家科学院院报,95,294-299(1998)和Quinn等的“用0.3毫米安培计微探测器测量的向大鼠皮下组织中传输糖的动力学”,Am.J.Physiol.269(内分泌代谢32),E155-E161(1995),其全文并入这里作为参考。
在一些实施方式中,来自处理电路109的数据被分析并被导向报警系统94以警告用户。在这些实施方式的至少一些中,发送器没有被用作探测器控制单元以执行包括分析数据和警告患者的所有这些所需的功能。
然而,在很多实施方式中,来自处理电路109的数据(例如电流信号、转换的电压或电频信号,或全部或部分的分析的数据)经皮肤上探测器控制单元44中的发送器98被传输到一个或多个接收器/显示器单元46、48。发送器具有天线93,如电线或类似导体,形成在护套45上。发送器98典型地被设计成传导信号高达2米或更多,优选高达5米或更多,更优选高达10米或更多。当传导到小的接收器/显示器单元46时,如掌上型、腰带型接收器。当传输到具有较好的天线的元件,如床边接收器时其有效范围较长。如下面将要详细描述的,接收器/显示器单元46、48的适当的例子包括可以很容易地穿戴或携带的单元或可以很方便地在病人睡着时放置在例如床头的单元。
发送器98典型地可根据处理电路109的复杂程度发送各种不同的信号到接收器/显示器单元46、48。例如,处理电路109可简单地提供未处理的信号,例如来自工作电极58的电流,没有用于温度或校准的任何校正,或处理电路109可提供例如利用电流-电压转换器131或141或电流-电频转换器获得的转换的信号。然后,任选使用温度和校准修正,未处理的测量结果或转换的信号可以经接收器/显示器单元46、48中的分析器152(见图22)处理,以确定分析物水平。在另一个实施方式中,处理电路109使用例如温度和/或校准信息校正未处理的测量结果,然后发送器98发送校准的信号和任选的温度和/或校准信息到接收器/显示器单元46、48。在另一个实施方式中,处理电路109任选以未处理的数据和/或校准的或温度信息的任何一种计算间质液和/或血液(根据间质液中的水平)中的分析物水平。在另外的实施方式中,处理电路109计算分析物浓度,但发送器98仅传输未处理的测量结果、转换的信号和/或校正的信号。
在一个可能的实施方式中,配置发送器98以利用码分多址联接方式(CDMA)传输。CDMA传输具有至少两个优点。首先,传输的信号变得很抗噪音。其次,从使用CDMA技术的发送器发送传输可以在接收点被辨别,尽管它们以相同的载波频率同时被发送。如图30所示,CDMA发送器234、236和238使用一组扩展码。以其最简单的形式,CDMA发送器(如234、236或238)使用两个扩展码(然而,CDMA发送器可以使用不止两个扩展码)。扩展码是用于代表一和零的较短的序列的一和零的序列。例如,使用两个扩展码的简单的CDMA发送器要使用一和零的一个序列以代表二进位一和一和零的不同序列以代表二进位零。代表一和零的较长的序列的每个一和零被称为“位”。在扩展码内的每个一和零被称为“码片”。因此,64个码片的序列可代表单个位。
如图30所示,如果每个CDMA发送器234、236和238使用不同的扩展码,从而代表在码片的不同序列中的一或零,则CDMA发送器234、236和238的多样性可以被可辨别地传导(即,在相同邻接区域内传导和可以被CDMA接收器单个识别)。图30中的发送器234、236和238各使用两个扩展码C0、C1、D0、D1、E0和E1。下标为零的扩展码代表“0”位。下标为1的扩展码代表“1”位。选择扩展码的每一个从而使它们两个两个地互不相关。说一下另一种方法,任何两个扩展码的标准化的内积是零:
(C0·C1)=(C0·D0)=(C0·D1)=(C0·D1)=(C0·E0)
=0(C0·E1)=(C1·D0)=(C0·D1)=(C1·E0)=(C1·E1)
=0(D0·D1)=(D0·E0)=(D0·E1)=(D1·E0)=(D1·E1)=0(E0·E1)=0
从图30可以看出,如果每个发送器同时传送代表“1”位的码片序列,它们的传送根据叠加原则结合,意味着所得的组合的传送等于用于每个发送器的代表“1”位的每个码片序列的总合:
C1+D1+E1
从图30还可以看出,可以配置CDMA接收器使其仅接收从特定发送器发出的传输。例如,在图30中,配置接收器240使其专门接收来自发送器234的传输。接收器240利用使输入信号对已知被发送器234使用的扩展码相关的相关器242和244。当对着结合的传输相关时,相关器242产生一个“0”输出,表示“ 0”位不能随着已经从发送器234发送而被发现:
C0·[C1+D1+E1]=(C0·C1)+(C0·D1)+(C0·E1)
=0+0+0
=0
当与结合的传输相关时,相关器244产生一个“1”的输出,代表“1”位随着已经从发送器234发送而已经被检出。
C1·[C1+D1+E1]=(C1·C1)+(C1·D1)+(C1·E1)
=1+0+0
=1
注意,来自发送器236和238的信号D1和E1的存在不能防止接收器240识别来自发送器234的发送。这是由于扩展码用作识别每个发送。可以使用制造方法,藉此每个发送器被指定一套属于它自己的扩展码,因此可以独一地识别各发送器。然而,由于制造商可能使用尽了独一套的扩展码,因此这些套可能在需要的时候重复使用。在重复使用方案中,当已经从较小群发送器发出时扩展码组会识别特定的传输,但是不能独一地识别各个发送器。
可以使用第二种制造方法,其中第一套扩展码会用于识别第一群发送器,第二套扩展码会用于识别第二群发送器(第n套扩展码会用于识别第n群发送器)。选择n套发送器的每一个以使用没有被其他扩展码组使用的码片序列。另外,每个发送器被连接到电化学探测器,以产生分析物监测装置,为了独一地识别每个发送器/分析物监测装置,可以编程和/或配置每个发送器以发送第二识别信号。例如,第二识别信号可包括:(1)ID码;(2)代表相关的探测器已经被植入的持续时间的值;(3)代表相关的探测器已经与发送器联合的持续时间的值。在后两种实施方案中,接收器被配置和安放了电路,该电路从其相关的发送器在其一定的容受度内排斥(antipate)一个值(例如探测器已经被植入的持续时间)。例如,假定与接收器成对的探测器已经在三个月前被植入。可以编程接收器以利用扩展码的校正组排除来自发送器的发送,但是显示与其相关的探测器已经被植入少于2分钟或大于4分钟。
通过代表“1”位或“0”位作为码片的长序列,消耗在发送中的谱空间增加。这种效果被在给定时期内发送的码片序列的Nyquist率高于在相同时期的位序列这一事实证实,因为当发送码片序列时必须发送大量的一和零。例如,如果64码片代表1位,则必须发送64个一和零以代表单个位,则谱被扩展64个因子。码片对位的比例被称为“过程增益”。一般来讲,过程增益越高,以特定的邻接关系进行可识别地发送的发送器的数目越大。发送器234、236和238使用过程增益足以允许至少两个发送器在相同区域内可识别地发送。更优选,发送器234、236和238使用过程增益足以允许至少四个发送器在相同区域中可识别地发送。还更优选发送器234、236和238使用过程增益足以允许至少八个发送器在相同区域中可识别地发送。还更优选发送器234、236和238使用过程增益足以允许至少十六个发送器在相同区域中可识别地发送。
发送器98可能遇见的一个难题是在广播媒体中存在干扰。图31显示了可以配置和安排发送器98从而以多个数据字发送数据讯息,其中多个数据字包括单个数据讯息,它被一连串错误校正位终止,错误校正位允许m位错误被检出和n位错误被校正(m和n的值由所使用的特殊错误校正方案来确定)。在图31中,数据讯息254被描绘由四个数据字246、248、250和252组成。数据讯息254可以由任何数目的数据字246、248、250和252组成,这里仅用四个数据字246、248、250和252组成是为了举例的目的。每个数据字246、248、250和252被描绘为由12位/码片B0-B47组成。再一次,尽管每个数据字246、248、250和252被描绘为由12位/码片B0-B47组成,但每个数据字246、248、250和252可以由任何数目的位/码片组成。
数据字246被描绘为由位的两个分开的字段256和258组成。第一个八位258被描绘成代表数据258。尽管第一个八位258被描绘成代表数据258,但任何数目的位都可以代表数据258。下四个位256被描绘成错误校正位256。尽管下四个位256被描绘成错误校正位256但任何数目的位都可以代表错误校正信息258。错误校正信息258允许接收器检出给定长度的错误,同时校正典型的较小大小的错误。可以检出或校正的错误的精确大小依赖于所用的特定错误校正方案。适当的错误校正方案的一个实例是Hamming码。为了说明的目的,应该假定错误校正信息256能够校正两位错误。例如,如果在数据字246中的两位是错误的,接收器将能够校正数据字成为它的原始形式,但是较大的错误则不能校正。
为了说明该系统的潜在的弱点,考虑了逐字传输序列。以这种传输序列,每个数据字内的数据位被序列地传输,直到整个数据字已经被传输,然后以相同的序列形式传输下一个字(以B0,B1,B2,......B10,B11,B12,......的顺序传输)。逐字传输序列的一个分支是假定每位x秒的传输率,干扰源持续超过2x秒会引起不可校正的数据错误,因为在数据字中的多于两位可能错误。为了保证能较好地抵抗这种形式的错误,可以使用交叉。
在建立在交叉原则上的传输序列下,配置和安排发送器98从而以不是序列行进的序列传输数据字内的位。例如,在一个可能的交叉序列中,发送器98被配置和安排成:(1)把多个数据字组合成为数据讯息,其具有在监视器下从体内的分析物水平得出的数据字之一的至少一部分;和(2)发送每个数据字B0,B12,B24和B36的第一位,之后是每个数据字B1,B13,B25和B37的第二位,以逐位的方式前进直到所有四个数据字都被传输。因此,假定每位x秒的传输率,干扰源必须持续8x秒以上(是逐字传输序列下所需的长度的4倍)才具有引起不可校正错误的能力。
皮肤上探测器控制单元44可能遇见的另一个潜在的难题是发送器98的传输频率随时间变化。为了克服这个潜在的难题,发送器可包括任选的可以将发送器的频率改回到所需的频率或频带的电路。图21中描述了这种适当的电路的例子,为开环电路调制系统200的框图。开环电路调制系统200包括相检波器(PD)210、电荷泵(CHGPMP)212、环路滤波器(L.F.)214、电压控制振荡器(VOC)216和由M分频(÷M)电路218分开形成的锁相环220。
分析物监测装置40使用开环电路调制系统200用于在发送器98和例如一个或多个接收器/显示器单元46、48的接收器之间的RF通讯。设计这种开环电路调制系统200以在发送器和它相关的接收器之间提供可信的RF链接。该系统使用调频,并利用传统的锁相环(PLL)220锁定载波中心频率。在操作中,在调制前先打开锁相环220。在调制锁相环220期间保持打开直到发送器的中心频率在接收器的波段内为止。当发送器检出中心频率要移到接收器波段的外面时,则发信号给接收器以等待,同时捕获中心频率。捕获到之后,继续开始发送。捕获中心频率、打开锁相环220、调制和在捕获中心频率这个周期要重复所需要的多个周期。
环控制240检测锁相环220的锁定条件并负责关闭和打开锁相环220。与环路控制240联结的加法器250检测中心频率的状况。调制控制260负责产生调制信号。配置发送放大器260以确保充足的发送信号能源。从非常稳定的信号源产生标准频率(未显示),并被N分频(÷N)模块270进行N分频。数据和控制信号经DATABUS280和CONTROL BUS290由开环电路调制系统200接收。
在锁相环220关闭状态下开环电路调制系统200开始运行。当由环路控制240检出锁定状态时,锁相环220被打开并且调制控制230开始产生调制信号。加法器250监测VCO频率(被M除)用于编程的间隙。监测到的频率与加法器250中编程的阈值相比较。这个阈值对应于接收器的媒介的频率级数的3dB截断频率。当监测的频率接近阈值时,通知环路控制240,并发送备用码到接收器和关闭锁相环220。
在这一点上接收器处于等待状态。发送器中的环路控制240关闭锁相环220。然后,调制控制230脱线,重置加法器250监测到的值,并锁定锁相环220。当环路控制240检测到锁定状态时,环路控制240打开锁相环220,将调制控制230连线并重新开始向接收器的数据传输,直到锁相环220的中心频率接近阈值,在这一点上,开始发送备用码的周期。N分频模块270和M分频模块218设置发送器的频道。
因此,开环调制系统200提供了用于分析物监测系统的可信的低能量FM数据传输。开环调制系统200提供宽带频率调制,而载波的中心频率保持在接收器的波段内。寄生电容和吸引发送器的中心频率的感应器被锁相环220校正。另外,加法器250和环路控制240提供中心频率飘浮检测的新方法。最后,开环电路调制系统200在CMOS过程中很容易被实现。
发送器98发送数据的速率可以与探测器电路97获得信号和/或处理电路109提供数据或信号到发送器的速率相同。或者,发送器98可以较慢的速率发送数据。在这方面,发送器98在每次发送时可发送不止一个数据点。或者,在每次数据发送时仅有一个数据点可被发送,剩余的数据不被发送。典型地,至少每一小时,优选至少每个15分钟,更优选至少每个5分钟,最优选至少每个1分钟有数据被发送到接收器/显示器单元46、48。然而,也可以使用其它数据传输速率。在一些实施方式中,当条件被指明,例如低水平或高水平的分析物或将要出现低水平或高水平分析物时,处理电路109和/或发送器98的结构可以以较快的速率处理和/或发送数据。在这些实施方式中,加速的数据发送速率典型地至少是每隔5分钟,并优选至少每隔1分钟。
除了发送器98以外,在皮肤上探测器控制单元44中可包括任选的接收器99。在一些情况下,发送器98是既可作为发送器又可作为接收器的收发机。接收器99可用来接收用于探测器42的校准数据。校准数据可被处理电路109用来校正来自探测器42的信号。这个校准数据可被接收器/显示器单元46、48发送或从其他来源例如医生的办公室内的控制单元发出。另外,任选的接收器99可用来接收来自接收器/显示器单元46、48的信号,如上所述,以指引发送器98,例如改变频率或频带、激活或灭活任选的报警系统94(如下所述),和/或指引发送器98以高速发送。
可以各种方法获得校准数据。例如,校准数据可以简单地是因素确定的校准测量,它可以使用接收器99被输入到皮肤上探测器控制单元44中,或者可以储存在皮肤上探测器控制单元44内的校准数据存储单元100内(在这种情况下不需要接收器)。校准数据存储单元100可以是例如可读的或可读/可写存储电路。
另一个或另外的校准数据可以基于由医生或一些其他专业人员或病人自己操作的试验而提供。例如,对于糖尿病患者来说,使用市售的测试盒测定它们自己的血糖浓度是很平常的。如果适当的输入装置(例如键盘、任选的信号接收器或用于连接键盘或计算机的端口)被连接到皮肤上探测器控制单元的话,这种测试的结果可以或者被直接输入到皮肤上探测器控制单元44,或者通过输入校准数据到接收器/显示器单元46、48并发送该校准数据到皮肤上探测器控制单元44而间接地输入。
独立地确定分析物水平的其他方法也可用于获得校准数据。这种类型的校准数据可以代替或补充因素确定的校准值。
在本发明的一些实施方式中,周期性间隔,例如每8个小时、一天一次、或一周一次可能需要校准数据以确定能够报道准确的分析物水平。在每次植入新的探测器42时可能需要校准,或者如果探测器超过阈值的最低值或最高值,或者如果探测器信号的变化率超过阈值是需要校准。在一些情况下,在植入探测器42后校准之前可能需要等待一段时间,以使探测器42获得平衡。在一些实施方式中,探测器42仅仅在它被植入后才被校准。在其他实施方式中,探测器42不需要校准。
皮肤上探测器控制单元44和/或接收器/显示器单元46、48可包括需要校准数据的可听或可视指示器,校准数据的需要是基于例如在校准之间的预定的间隔时间或新的探测器42被植入。皮肤上探测器单元44和/或接收器/显示器单元46、48还可包括提醒病人信息,诸如由分析物检测装置40报告的分析物水平的可听或可视指示器,这种分析物水平可能不准,因为在预定时间间隔内和/或在植入新的探测器42后还没有进行探测器42的校准。
皮肤上探测器控制单元44的处理电路109和/或接收器/显示器单元46的分析仪可决定什么时候需要校准数据和校准数据是否可接受。皮肤上探测器控制单元44可任选被构成在例如下列情况下不允许校准或排斥校准点:1)来自温度探针的温度读数表明温度不在预定可接收范围内(例如30-42℃或32-40℃)或温度变化很迅速(例如0.2℃/分钟,0.5℃/分钟或0.7℃/分钟或更大);2)两个或多个工作电极58提供未校准信号不在预定范围内(例如彼此在10%或20%内);3)未校准信号的变化率在阈值以上(例如0.25mg/dL/分钟或更大);4)未校准信号超过阈值的最大值(例如5、10、20或40nA)或低于阈值的最小值(例如0.05、0.2、0.5或1nA);5)校准信号超过阈值最大值(例如信号对应于200mg/dL、250mg/dL或300mg/dL的分析物浓度)或低于阈值最小值(例如信号对应于50mg/dL、65mg/dL或80mg/dL的分析物浓度);6)植入后的时间不够(例如10分钟或更少、20分钟或更少或30分钟或更少)。
如果最后一次校准之前和之后使用探测器数据确定的值超过阈值,表明校准可能不正确或者探测器特征已经在校准之间根本改变,则处理电路109或分析仪152可能请求另一次校准点。这个另外的校准点可表明差异的来源。
皮肤上探测器控制单元44可包括任选的数据存储单元102,它可以用于永久性地,或更典型地为暂时性地存储来自处理电路109的数据(来自探测器的测量结果或处理的数据)。数据存储单元102可存储数据,使得数据可以被处理电路109用来分析和/或预测分析物水平的趋势,包括例如分析物浓度增加或减少的速率和/或加速度。数据存储单元102还可以或者可用于在接收器/显示器单元46、48不在范围内期间存储数据。当数据的存储速率低于数据的获得速率时,数据存储单元102还可用于存储数据。例如,如果数据获得速率是10点/分,传输是2传输/分,则根据所需的用于处理数据点的速率,每次传输可发送数据的1/5点。数据存储单元102典型地包括可读/可写记忆存储装置和典型地还包括硬件和/或软件以写和/或读取记忆存储装置。
皮肤上探测器控制单元44还可包括任选的报警系统104,它可根据来自处理电路109的数据告知病人存在潜在的分析物有害状态。例如,如果分析物是糖,则皮肤上探测器控制单元44可包括警告病人诸如低血糖、高血糖、即将发生低血糖和/或即将发生高血糖的报警系统104。报警系统104在来自处理电路109的数据达到或超过阈值时启动。用于血糖水平的阈值的例子是约60、70或80mg/dL为低血糖;约70、80或90mg/dL为即将发生低血糖;约130、150、175、200、225、250或275mg/dL为即将发生高血糖;和约150、175、200、225、250、275或300mg/dL为高血糖。设计到警报系统104中的实际阈值对应于间质液中糖浓度或电测量结果(例如通过电流测量结果转换而获得的电流值或电压值),它与上述血糖水平相关。分析物检测装置可配置成使得可由病人和/或医学专业人员编程用于这些或其他条件的阈值水平。
如果数据点具有一个值在阈值之外,则在表明特殊状况的方向超过阈值。例如,与200mg/dL相关的糖水平的数据点超过高血糖的180mg/dL阈值,因为数据点表明该病人已经进入高血糖状态。还有另一个例子,与糖水平65mg/dL相关的数据超过低血糖70mg/dL的阈值,因为该数据点表明该病人是如阈值定义的低血糖。然而,与75mg/dL糖水平相关的数据点不超过低血糖的同样的阈值,因为该数据点不表明如选定的阈值所定义的特殊状况。
如果探测器读数表明一个值在探测器42的测量结果之外,则启动警报器。对于糖来说,间质液中的糖水平生理相关测量范围是典型的约50到250mg/dL,优选大约40-300mg/dL,理想的是30-400mg/dL。
当分析物水平增加或降低的变化率或加速度达到或超过阈值或加速度时,也可以或选择启动警报系统104。例如,在皮下糖监测器的情况下,如果糖浓度的变化率超过表明高血糖或低血糖状态可能发生的阈值时,也可以启动警报系统104。可以配置任选的报警系统104,使其在单个数据点满足或超过特定阈值时被启动。或者,仅仅在预定数目的数据点跨过满足或超过阈值的预定的时间量时才启动警报系统104。可启动警报系统的每个条件可具有不同的警报启动条件。另外,警报启动条件可根据电流状况而改变(例如即将发生高血糖的指示可改变数据点的数目或被测试以确定高血糖的时间的量)。
警报系统104可包括一个或多个单独的警报器。每个警报器可单独地被启动以指示分析物的一个或多个状态。警报器可以是例如可听或可视的。也可以使用其它感官刺激的警报系统,包括在启动时产生热、冷、振动或产生温和电击。在一些实施方式中,警报器是可听的,具有不同的音调、旋律或表明不同状况的音量。例如,高旋律可以表明高血糖,低旋律可以表示低血糖。可视警报器可使用不同的颜色、亮度或皮肤上探测器控制装置44上的不同位置,以表明不同状况。在一些实施方式中,可听警报器系统被配置成使得警报的音量随时间增加直到警报器被关闭。
在一些实施方式中,警报器可以在预定时间后自动关闭。在其他一些实施方式中,警报器可以被配置成当数据不再表明激发警报的情况存在时则自动关闭。在这些实施方式中,当单个数据点表明不再存在启动警报的情况时可关闭警报器,或者仅仅在给定时间段中获得的预定数目的数据点或平均数据点表明情况不再存在时才关闭警报器。
在一些实施方式中,除了自动关闭或者作为选择,警报器可以由病人或任何其他人员手动关闭。在这些实施方式中,配置一个开关,可用来关闭启动的警报器。所述开关可以通过例如操作皮肤上探测器控制单元44或接收器/显示器单元46、48上的促动器来可操作性地咬合(或根据开关的结构而脱离)。在一些情况下,可以在两个或多个单元44、46、48上配置促动器,它们中的任何一个都可以被促动以关闭警报器。如果在接收器/显示器单元46、48上配置开关101和/或促动器,则信号可以从接收器/显示器单元46、48被传输到皮肤上探测器控制单元44上的接收器98以关闭警报。
可以使用多种开关,包括例如机械开关、簧片开关、霍耳效应开关、Gigantic Magnetic Ratio(GMR)开关(GMR开关的电阻是与磁场有关的)等。优选用于可操作性地咬合(或脱离)开关的促动器被放置在皮肤上的探测器控制单元44上,并被配置成使不能允许水流入按钮周围并进入护套。这种按钮的一个例子是完全被整合到护套上的柔性聚合物或塑料涂层覆盖的柔性导电带。柔性导电带开启的位置是从护套上弓起和凸出。当由病人或其他人员按下时,柔性导电带被压下直接朝向金属触点并闭合电路以使警报器关闭。
对于簧片开关或GMR开关,可以使用一件在弓起或凸起于护套45上的磁性材料,如永久性磁铁或电磁铁和簧片或GMR开关。通过按下使磁性材料接近开关并引起开关内的磁场增加的柔性促动器可以从簧片开关或GMR开关。
在本发明的一些实施方式中,分析物监测装置40仅包括皮肤上探测器控制单元44和探测器42。在一些实施方式中,皮肤上探测器控制单元44的处理电路109能够确定分析物的水平和如果分析物水平超过阈值则激活警报系统104。在这些实施方式中,皮肤上探测器控制单元44具有报警系统104和还包括显示器,如下面将要讨论的关于接收器/显示器46和48。优选显示器是LCD或LED显示器。皮肤上探测器控制单元44可以没有发送器,除非例如需要发送数据到例如医生的办公室的控制单元。
皮肤上探测器控制单元44还可以包括参考电压发生器101,用以提供绝对电压或电流用来与获自探测器42或用于探测器42的电压或电流进行比较。适当的参考电压发生器的实例是带隙参考电压发生器,它使用例如具有已知带隙的半导体材料。优选带隙是在操作期间半导体材料将要经历的温度范围内对于温度不敏感的带隙。适当的半导体材料包括镓、硅和硅酸盐。
可配置偏流发生器105以准确地加偏压到使用电晶体的电子元件上。可配置振荡器107以产生典型地用于数字电路的时钟信号。
皮肤上探测器控制单元44还可以包括一个监视器电路103,它测试电路,特别是在控制单元44中的任何数字电路以确定是否该电路运行正常。监视器电路操作的非限制形式实例包括:a)由监视器电路产生随机号、在存储位点存储该号,将该号写入监视器电路中的寄存器中,恢复该号以进行等同性比较;b)检查模拟电路的输出以确定该输出是否超过预定的动态范围;c)以预计的脉冲间隔检查用于信号的定时电路的输出。监视器电路的功能的其他实施例是本领域已知的。如果监视器电路检出错误,监视器电路会激活警报器和/或关闭装置。
接收器/显示器单元
可以给分析物监测装置40配置一个或多个接收器/显示器单元46、48,以很容易地存取由探测器42产生的数据,和在一些实施方式中处理来自皮肤上探测器控制单元44的信号以确定皮下组织中的分析物的浓度或水平。小的接收器/显示器单元46可以由病人携带。这些单元46可以是掌上型和/或可以适合佩带在腰带上或在手袋中或病人携带的钱包中。小的接收器/显示器单元46的一个实施方式具有例如呼机的外观,从而病人不会被识别出是使用医疗装置的人。这种接收器/显示器单元可任选具有单向或双向寻呼能力。
可以使用较大的接收器/显示器单元48。可设计这些较大的单元48以放置在架子上或床头。较大的接收器/显示器单元48可以由父母使用以在它们的孩子睡眠时监测他们或夜间惊醒病人。另外,较大的接收器/显示器单元48可以包括灯、时钟或方便的收音机和/或激活警报。可以使用一种或两种类型的接收器/显示器单元46、48。
图22以框图的形式描述了接收器/显示器单元46、48,它典型的包括接收器150,用于接收来自皮肤上探测器控制单元44的数据;分析仪152,用以评估数据;显示器154,用以给病人提供信息;和报警系统156,用以当条件变化时警告病人。接收器/显示器单元46、48还可任选包括数据存储装置158、发送器160和/或输入装置162。接收器/显示器单元46、48还可包括其他元件(未显示),如电源(例如电池和/或可以从壁装电源插座接收电能的电源),监视器电路、偏流发生器和振荡器。这些附加的元件与上面描述的用于皮肤上探测器控制单元44的类似。
在一个实施方式中,接收器/显示器单元48是由在家的病人使用的床边单元。这种床边单元包括接收器和一个或多个任选的物件,包括例如时钟、灯、可听警报器、电话连接和收音机。床边单元还具有显示器,优选具有较大的数字和/或字母可以在房间另一端读出。该单元可通过插入电源插座进行操作,和可以任选具有电池作为备用。床边单元典型地具有比掌上型单元好的天线,从而使床边单元的接收范围较长。
当表示一个警报时,床边单元可以例如激活可听警报器、收音机、灯和/或启动电话。该警报器可以比小的掌上型单元的强度更大,例如惊醒或刺激可能睡着、昏睡或不清醒的病人。另外,高声的警报器可以在夜间提醒父母监测糖尿病小孩。
床边单元可具有自己的数据分析仪和数据存储器。数据可以从例如皮肤上探测器单元或另一个接收器/显示器单元,例如掌上型或小的接收器/显示器单元传输。因此,至少一个单元具有所有相关的数据,使得没有明显的间隔就可以下载并分析数据。
床边单元任选具有可以安置小的接收器/显示器单元的界面或支架。床边单元可以利用小的接收器/显示器单元的数据存储能力和分析能力和/或在这个位置从小的接收器/显示器单元接收数据。床边单元还可以给小的接收器/显示器单元的电池充电。
接收器150典型地是使用已知的接收器和天线电路形成的,并经常被调或可调到皮肤上探测器控制单元44的发送器98的频率或频带。接收器150典型地能够从比发送器98的发送距离远的多的距离接收信号。小的接收器/显示器单元46典型地可以从远至2米,优选5米,更优选10米或更远的皮肤上探测器控制单元44接收信号。较大的接收器/显示器单元48,如床边单元典型地可以从远至5米,优选远至10米,更优选远至20米距离或更远的皮肤上探测器控制单元接收信号。
在一个实施方式中,使用转发器单元(未显示)用于加强来自皮肤上探测器控制单元44的信号,从而使信号可以被距离皮肤上探测器控制单元44很远的接收器/显示器单元46、48接收。转发器单元典型地是独立于皮肤上探测器控制单元44,但是,在一些情况下,可以设计转发器单元使其绑附在皮肤上探测器控制单元44上。转发器单元典型地包括用于从皮肤上探测器控制单元44接收信号的接收器和用于发送接收到的信号的发送器。通常,转发器单元的发送器比皮肤上探测器控制单元的发送器更强,尽管这是不必须的。转发器单元可被用在例如孩子的房间以从孩子身上的皮肤上探测器控制单元发送信号到父母房间的接收器/显示器单元,以监测孩子的分析物水平。另一个示例性用途是在医院里,使显示器/接收器单元在护士站,用于监测一个或一些病人的皮肤上探测器控制单元。
其他装置的存在,包括其他皮肤上探测器控制单元可产生噪音或在发送器98的频带内产生干扰。这可导致错误数据的产生。为了克服这个潜在的难题,发送器98也可以发送密码,以在接收器/显示器单元46、48范围内不止一个皮肤上探测器控制单元44或其他发送源存在的情况下,指示例如发送的开始和/或识别、优选使用独一的标适码以识别特定的皮肤上探测器控制单元44。带有数据的标识码的提供可以减少接收器/显示器单元46、48截取和翻译来自其他发送源的信号的可能性,以及防止与不同的皮肤上探测器控制单元44发生“交扰”。标识码可以被提供并储存在探测器控制单元44中作为因子设定码(factory-set code)。或者,可以由探测器控制单元44或接收器/显示器单元46、48(和发送到探测器控制单元44)中的适当的电路产生随机的标识码,或者可以由病人挑选标识码和经发送器或连接到探测器控制单元44的输入装置传输到探测器控制单元44。
可以使用其它方法以消除“交扰”并识别来自适当的皮肤上探测器控制单元44的信号。在一些实施方式中,发送器98可使用编密码技术以加密来自发送器98的数据流。接收器/显示器单元46、48包含译解加密的数据信号的密钥。然后,接收器/显示器单元46、48通过评估解密后的信号来确定什么时候接收到假信号或“交扰”信号。例如,在一个或多个接收器/显示器单元46、48中的分析仪152将诸如电流测量结果或分析物水平这些数据与预计的测量结果(例如对应于相关的分析物水平的测量结果的预计范围)相比较。或者,接收器/显示器单元46、48中的分析仪搜索解密的数据信号中的标识码。
另一个用以消除“交扰”、通常与标识码联合的方法或加密方案包括在皮肤上探测器控制单元44中提供一个任选的机构,用于在确定存在“交扰”时改变发送频率或频带。这个用以改变发送频率或频带的机构可以由接收器/显示器单元在发现存在交扰或干扰的可能性时自动启动,或者由病人手动操作。对于自动启动来说,接收器/显示器单元46、48发送信号到皮肤上探测器控制单元44上的任选的接收器99以指导皮肤上探测器控制单元44的发送器98改变频率或频带。
手动启动频率或频带的变化可通过例如使用接收器/显示器单元46、48和/或皮肤上探测器控制单元44上的促动器(未显示)来完成,它是由病人操作以指导发送器98改变频率或频带。手动启动发送频率或频带的改变的操作可包括通过来自接收器/显示器单元46、48和/或皮肤上探测器控制单元44的听觉或视觉信号促使病人启动频率或频带的改变。
如参考图30所进行的详细的描述,每个接收器150可通过使用与发送器98合作的CDMA技术来减少“交扰”。可以使接收器150与已知被用于特定发送器98的一组扩展码关联,从而消除从不使用这一组扩展码的发送器发出的交扰。特定发送器98/接收器150配对以排斥交扰的能力部分依赖于过程增益。一般来说,过程增益越高,配对以排斥交扰的能力越好。在一个实施方式中,接收器150使用足以允许至少两个发送器以相同的距离可识别地发送的过程增益。在一个实施方式中,接收器150可使用足以允许至少四个发送器以相同的距离可识别地发送的过程增益。在另一个实施方式中,接收器150可使用足以允许至少四个发送器以相同的距离可识别地发送的过程增益。在另一个实施方式中,接收器150可使用足以允许至少八个发送器以相同的距离可识别地发送的过程增益。还有另一个实施方式,接收器150可使用足以允许至少十六个发送器以相同的距离可识别地发送的过程增益。
再来看接收器150,由接收器150接收的数据然后被发送到分析仪152。分析仪152可以有多种功能,类似于皮肤上探测器控制单元44的处理电路109,包括1)使用校准数据和/或来自温度探针66的测量结果修改来自探测器42的信号;2)确定间质液中分析物的水平;3)根据间质液中探测器的测量结果确定血液中的分析物水平;4)确定是否分析物的水平、变化率和/或分析物变化率中的加速度超过或满足一个或多个阈值;5)如果阈值满足或超过则启动警报系统156和/或94;6)根据一系列探测器信号评估分析物水平的趋势;7)确定药物的剂量,和8)减小噪音或误差的作用(例如通过将信号平均或将来自多个电极的读数进行比较)。分析仪152可以很简单,并且仅执行一个或少数这些功能,也可以执行全部或大多数这些功能。
分析仪152可执行与调节检测到的分析物水平相关的计算,以校正温度的影响。如参考图29所讨论的,分析仪152可以设计成能根据温度每变化±1℃斜率变化±6%的关系调节已知的探测器电流-分析物水平曲线使其斜率更大或更小。如果确定存在不同的温度依赖性,则可以设计、编程或安排分析仪152仪调节曲线来模拟确定的依赖性。分析仪152可采取微处理器、数字逻辑或ASIC和本领域中已知的其他形式。
来自分析仪152的输出典型地被提供给显示器154。可使用各种显示器154,包括阴极射线管显示器(特别用于较大的单元)、LED显示器、或LCD显示器。显示器154可以是单色的(例如黑色或白色)或多色的(即具有彩色范围)。显示器154可包含在一定条件下(例如当一个条件,例如高血糖时,被来自探测器42的信号指示使该特定字符在显示器上变成可见的)被激活的字符或其他标识符。显示器154还可以包含两个复杂的结构,如LCD或LED文字数字结构,它的一部分可以被激活以产生字母、数字或符号。例如,显示器154可包括一个区域164,用于数字显示分析物的水平,如图23所示。在一个实施方式中,显示器154还提供一个讯息给病人以指示该病人采取行动。这种讯息可包括例如如果病人出现低血糖则提示病人“吃糖”,如果病人高血糖,则提示病人“使用胰岛素”。
图23显示了接收器/显示器单元46、48一个示例。这种特定的接收器/显示器单元46、48的显示器154包括显示分析物水平,例如由处理电路109和/或分析仪152利用来自探测器42的信号确定的血糖浓度的部分164。显示器还包括可以在某一特定条件下被激活的各种指示器166。例如,如果病人是高血糖,则糖监测装置的指示器168被激活。在低血糖(170)、即将发生高血糖(172)、即将发生低血糖(174)、故障、错误条件或需要校准样本的时候可以激活其他指示器。在一些实施方式中,可以使用彩色编码的指示器。或者,显示血糖浓度的部分164还可包括复合指示器180(见图24),其一部分可以被适当地激活以指示上述条件的任何一个。
显示器154还可以显示一段时期内的分析物水平的图表178,如图24所示。可用的其他图表的例子包括在一定时间内分析物水平的变化率或变化率的加速度。在这些实施方式中,接收器/显示器单元被配置成能够使病人选择病人希望看见的特定的显示器(例如血糖浓度或浓度-时间的图表)。通过按压按钮等,例如任选的输入装置162,病人可以选择所需的显示模式。
接收器/显示器单元46、48典型地还包括报警系统156。对于报警系统156的配置的选项类似于皮肤上探测器控制单元44的报警系统104中的那些。例如,如果分析物是糖,则皮肤上探测器控制单元44可包括警告病人一些情况,例如低血糖、高血糖、即将发生低血糖和/或即将发生高血糖的警报系统156。当来自分析仪152的数据达到或超过阈值时,则警报系统156被触发。阈值可对应于间质液糖浓度或探测器信号(例如电流或转换的电压值),它与上述血糖值相关。
报警系统156还可以,或作为选择,当分析物水平的增加或降低的速率或加速度达到或超过阈值时被启动。例如,在使用皮下糖监测装置的情况下,如果糖浓度的变化率超过表示高血糖或低血糖情况将要发生的阈值时,报警系统156就会被启动。
可以配置报警系统156使其在单个数据点满足或超过特定阈值时被启动。或者,报警系统仅仅在跨过预定时间段的预定数目的数据点满足或超过阈值时被启动。作为另一种选择,报警系统仅仅在跨过预定时间的数据点具有满足或超过阈值的平均值时才被启动。可触发警报器的每个条件可具有不同的报警激活条件。另外,报警激活条件可根据当前的情况而改变(例如即将发生高血糖的指示可改变数据点的数目或被测试以确定高血糖的时间的量)。
报警系统156还可包括一个或多个单独的警报器。每个警报器可单独地被激活以指示分析物的一种或多种条件。例如,警报器可以是可听见的或可视的。其他可使用的探测器刺激报警系统可包括使皮肤上探测器控制单元44产生热、冷、振动或产生温和的电刺激的报警系统156。在一些实施方式中,警报器是可听的,具有不同的音调、旋律或表明不同状况的音量。例如,高旋律可以表明高血糖,低旋律可以表示低血糖。可视警报器可使用不同的颜色,亮度以表明不同状况。在一些实施方式中,可听警报器系统被配置成使得警报的音量随时间增加直到警报器被关闭。
在一些实施方式中,警报器可以在预定时间后自动关闭。在其他一些实施方式中,警报器可以被配置成当数据不再表明激发警报的情况存在时则自动关闭。在这些实施方式中,当单个数据点表明不再存在启动警报的情况时可关闭警报器,或者仅仅在给定时间段中获得的预定数目的数据点或平均数据点表明情况不再存在时才关闭警报器。
在一些实施方式中,除了自动关闭或者作为选择,警报器可以由病人或任何其他人员手动关闭。在这些实施方式中,配置一个开关,可用来关闭启动的警报器。开关可以通过例如操作皮肤上探测器控制单元44或接收器/显示器单元46、48上的促动器来可操作性地咬合(或根据开关的结构而脱离)。报警系统156的一个结构具有在警报即将发生情况(例如即将发生低血糖或高血糖)时一段时间后自动关闭,和警报表示当前情况(例如低血糖或高血糖)的手动关闭。
接收器/显示器单元46、48还可包括许多任选的物件。一个物件是数据存储单元158。该数据存储单元158可用于存储数据,以在分析仪152被配置成用来确定分析物水平的趋势时使用。数据存储单元158还可用来存储可能从另一个接收器/显示器单元,如较大的显示单元48上下载的数据。或者,数据可以被下载到计算机或者病人家中、医生办公室等的另外的数据存储装置上,用来评估分析物水平的趋势。在接收器/显示器单元46、48上可配置一个端口(未显示),通过它,可以将存储的数据转发或利用任选的发送器160转发。还可以激活数据存储单元158以在病人经由例如任选的输入装置指令时用来存储数据。数据存储单元158还可被构制成用来在发生特定情况,例如高血糖或低血糖事件、运动、吃饭时存储数据。存储单元158还可以存储事件标记,上面带有特定事件的数据。这些事件标记可经由显示器/接收器单元46、48自动产生,或通过病人的输入产生。
接收器/显示器单元46、48还可包括任选的发送器160,它可被用来发送:1)校准信息;2)命令皮肤上探测器控制单元44的发送器98改变发送频率或频带的信号;和/或3)激活皮肤上探测器控制单元44的警报系统104的信号,所有这些都如上面所述。发送器160典型地以不同于皮肤上探测控制单元44的发送器98的频带操作,以避免在发送器98、160之间发生交扰。如上面关于皮肤上探测器控制单元44的发送器100所进行的描述一样,可利用一些方法来减少交扰和假信号的接收。在一些实施方式中,发送器160仅被用来发送信号到探测器控制单元44,并具有少于1英尺、优选少于6英寸的范围。这需要在发送数据,例如在发送校准信息时病人或另外的人拿着接收器/显示器单元46靠近探测器控制单元44。也可以使用RF传输以外的方法进行发送,包括光学或电线传输。
另外,在本发明的一些实施方式中,发送器160还可被构制成可传输数据到另一个接收器/显示器单元46、48或一些其他的接收器。例如,小的接收器/显示器单元46可传输数据到较大的接收器/显示器单元48,如图1所示。另一个实施例中,接收器/显示器单元46、48还可传输数据到病人家里或医生的办公室中的计算机。另外,发送器160或分立的发送器还可指挥向另一个单元或电话机或另外的通讯装置发送,以在警报器被启动和/或预定时间后启动的警报器没有被关闭的情况下警告医生或其他的个人。在一些实施方式中,接收器/显示器单元能够单向或双向寻呼和/或连接到电话线以发送和/或从另一个如监视病人的健康专家接收讯息。
用于接收器/显示器单元46、48的另一个任选的元件是输入装置162,如键区或键盘。输入装置162可允许输入数字或字母。输入装置162也可以包括按钮、键、或其他能触发分析物监测装置40的功能和/或提供输入到分析物监测装置40的元件。这些功能可包括触发数据传输、手动改变发送器98的传输频率或频带、关闭报警系统104、105、输入校准数据和/或指示一个事件以启动代表该事件的数据的储存。
输入装置162的另一个实施方案是触摸屏。可以将触摸屏连接到显示器154上或可以是分离的显示器。当病人触摸对应于所需功能的由“软钮”表示的屏幕区域时,触摸屏被激活。触摸屏是众所共知的。
另外,分析物监测装置40还可以包括口令保护,以避免未授权地发送数据到终端或未授权地改变装置40的设置。无论何时当口令保护功能被启动时,显示器154会提示病人使用输入装置152输入口令。
可以由输入装置162激活的另一个功能是关闭模式。关闭模式可以指示接收器/显示器单元46、48不再显示一部分或全部数据。在一些实施方式中,关闭模式的启动甚至还关闭了警报系统104、156。优选督使病人确认这个特殊的动作。在关闭模式期间,处理电路109和/或分析仪152可停止处理数据或它们可以继续处理数据但不向显示器报告,或任选存储数据用于以后提取。
或者,如果输入装置162在预定时间内没有被激活,则可以进入睡眠模式。这个时期可以由病人或其他个体调节。在睡眠模式期间,处理电路109和/或分析仪152典型地继续获得测量数据并处理数据,然而显示器不被激活。睡眠模式可以通过诸如启动输入装置162等操作来关闭。然后可以显示电流分析物读数或其他所需的信息。
在一个实施方式中,当在预定时间内单元46没有接收到来自皮肤上探测器控制单元的传输时,接收器/显示器单元46触发可听或可视警报器。警报典型地会一直持续直到病人反应和/或接收到传输。如果接收器/显示器单元46被遗忘在身后,这可以例如提醒病人。
在另一个实施方式中,接收器/显示器单元46、48中连接了一个校准单元(未显示)。例如,接收器/显示器单元46、48可包括传统的血糖监测器。另一个利用分析物浓度的电化学检测的有用的校准装置公开在美国专利申请号08/795767中,其全文并入这里作为参考。可以使用的其他装置包括那些利用例如电化学和比色法血糖分析、间质液或皮肤液体的分析、和/或非侵入性光学分析。当植入的探测器需要校准时,病人使用整合到体内的监测器以产生读数。然后,该读数可以由接收器/显示器单元46、48的发送器160自动地发送以校准探测器42。
药物管理系统的结合
图25描绘了本发明的基于探测器的给药系统250的框图。该系统可以响应来自探测器252的一个或多个信号以提供药物用于对抗高或低的分析物水平。或者,该系统监测药物浓度以确保药物保持在所需的治疗范围内。药物传输系统包括一或多个(优选两个或多个)皮下植入的探测器252、皮肤上探测器控制单元254、接收器/显示器单元256、数据存储和控制模块258、和药物管理系统260。在一些情况下,接收器/显示器单元256、数据存储和控制模块258和药物管理系统260可集成到一个单元内。基于探测器的给药系统250使用来自一个或多个探测器252的数据以提供用于数据存储和控制器模块252的算法/机构的必须的输入,来调节给药。如一个实施例,可以使用糖探测器以控制和调节施用的胰岛素。
在图25中,探测器252产生与病人的药物或分析物水平相关的信号。分析物的水平将依赖于给药系统输送的药物的量。如图25所示,皮肤上探测控制单元254或接收器/显示器单元256中的处理器262确定分析物的水平,和可能的其他信息,如分析物水平的增加或降低的速率或加速度。如图25所示,这个信息然后被皮肤上探测器控制单元254或非集成的接收器/显示器单元256中的发送器264发送到数据存储和控制模块258。
如果给药系统250具有两个或多个探测器252,则在接收数据之前,数据存储和控制器模块258会校验来自两个或多个探测器252的在预定的参数范围内的数据作为有效数据。然后,任选与前面获得的数据一起,该数据可以被数据存储和控制器模块258处理,以确定给药方案。然后使用药物管理系统260执行给药方案,药物管理系统260可以是内部或外部的输注泵、注射器、透皮传输系统(例如贴在皮肤上的包含药物的贴剂)或吸入系统。或者,药物存储和控制器模块258可提供一个给药方案,从而使病人或其他人员可以根据该方案提供药物给病人。
在本发明的一个实施方案中,数据存储和控制模块258是可训练的。例如,数据存储和控制器模块258可存储一段时间例如几周的糖读数。当遇到低血糖或高血糖情况时,可以分析引起这种事件的相关历史,以确定可以改善系统的能力的任何方式从而预测未来的事件。之后的数据可以与已知的方式进行比较以预测低血糖或高血糖并相应地传输药物。在另一个实施方案中,通过外部系统或通过皮肤上探测器控制单元254中的处理电路109,或接收器/显示器单元256中的分析仪152来进行趋势分析,并将该趋势输入到数据存储和控制器258。
在一个实施方式中,数据存储和控制器模块258、处理电路109、和/或分析仪152利用来自多个事件的病人特异的数据以预测病人对未来事件的反应。用于该预测中的多个事件是对相同或类似的外部或内部刺激的典型反应。刺激的实例包括低血糖或高血糖发生的时期(或用于除了糖以外的其他分析物的相应的条件)、治疗的情况、药物传输(例如用于糖的胰岛素)、食物摄取、锻炼、禁食、体温变化、体温的升高或降低(例如发烧)、和疾病、病毒、感染等。通过分析多个事件,数据存储和控制器模块258、处理电路109、和/或分析仪152可大致地预测未来事件的发生并提供例如给药方案或根据该分析给药。可以由病人或其他人使用输入装置(未显示)以指示当遇到特殊情况时,数据存储和控制器模块258、处理电路109、和/或分析仪152可以追踪该数据作为来自特定事件的结果,用于以后的分析。
另外,给药系统250能提供随时的(on-going)药物敏感性反馈。例如,在通过药物管理系统260给药期间获得的来自探测器252的数据可提供关于各个病人对药物的反应的数据,这反过来又可以用于立即或在将来相应地修改当前的给药方案。可提取的用于各个病人的所需数据的实例包括病人对给药的反应的特定时间常数(例如当给予胰岛素推注时糖浓度下降的如何迅速)。另一个实施例是病人对给药的各种剂量的反应(例如病人的药物敏感性曲线)。相同的信息可以存储在数据存储和控制器模块中,然后用于确定病人的药物反应趋势,这可用于开发之后的给药方案,从而给需要该药物的病人个性化的给药程序。
本发明不应该被认为仅限于上面所述的特定实施例,而应该认为覆盖后面所附的权利要求中定义的所有本发明的方面。本领域技术人员参考本发明这里给出的具体实施例进行的各种修改、等同处理以及可用于本发明的各种结构都涵盖在本发明的范围内。权利要求书意在包括所有这种修改和装置。

Claims (4)

1. 一种传达代表体液中分析物水平的数字信号的方法,该方法包括:把多个数据字组合成为数据讯息,其中至少一个数据字包含从代表体液中分析物水平的数字信号得出的数据,每个数据字包含一个位组,其中对于至少两个数据字来说,所述位组被组织成一组数据位和一组错误校正位;和
发送数据讯息,使包含组合成数据讯息的多个数据字之一的位不相邻地发送。
2. 权利要求1的方法,其中把多个数据字组合成为数据讯息包括把多个数据字组合成为数据讯息,其中对于每个数据字来说,所述位组被组织成一组数据位和一组错误校正位。
3. 权利要求1的方法,进一步包括:
收集代表体液中分析物水平的模拟信号;
把该模拟信号转换成为代表体液中分析物水平的数字信号。
4. 权利要求3的方法,其中发送数据讯息包括发送组合成数据讯息的每个数据字的第一位,之后是组合成数据讯息的每个数据字的第二位,继续发送组合成数据讯息的每个数据字的下一个位直到整个数据讯息已经全部被发送为止。
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