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一般来说，心率监测的原理通常分三种：一种是光电透射测量法，原理上来说就是手环与皮肤接触的传感器会发出一束光打在皮肤上，测量反射/透射的光。因为血液对特定波长的光有吸收作用，每次心脏泵血时，该波长都会被大量吸收，以此就可以确定心跳。不过缺点是耗电量大，同时会受环境光干扰。目前市面上的智能手环或手表监测心率的功能多是采用了光电透射测量法。
还有一种方法是测试心电信号的方法，手环的传感器可以通过测量心肌收缩的电信号来判断使用者的心率情况，原理和心电图类似原理。缺点是电路比较复杂，占PCB空间比较大，易受电磁干扰，同时传感器必须紧贴皮肤，放置位置相对固定，所以很难有手环采用这种测量方式。
除此之外，还有振动式测量，最近才有产品出来。 因为每次心跳都会引起身体的震动，通过高精度的传感器捕捉这种震动，再经过信号处理可以得到心跳，一般来说，智能坐垫或智能按摩器一类的产品多会采用这种测量方法，手环则比较少见。
目前市面上常见的智能穿戴设备具备测量心率功能的如智能手环、手表，大多采用的是光电心率模块进行测量，如小米手环2及华米运动手表，采用的均为光电容积脉搏波描记法（PhotoPlethysmoGraphy），简称PPG，来监测心率。原理很简单：血液是红色的，反射红光，吸收绿光。小米手环2结合绿色LED光跟感光光电二极管，检测特定时间手腕处流通的血液量，从而获取心率信息。
而小米手环当中独特的心率算法2.0，可在此基础上更加精确的测量心率数据。
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