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目的探讨正常人右胸导联心电图男女P波形态差异及变化规律。方法测量900名正常人右胸导联心电图,男女对半,分析P波形态及变化规律。结果右胸导联心电图P波以直立和正负双相P波为主。V1导联直立P波的发生率明显多于正负双相P波的发生率(p<0.01)。从V1～V6R直立P波的发生率依次减少,正负双相P波的发生率依次增多至V4R时,平坦、倒置P波的发生率逐导增多。从V1至V6RP波形态变化以均直立、均正负双相及由直立向正负双相的居多。直立P波振幅及正负双相P波的正相波振幅依次减小并变窄,负相波振幅依次增大并变宽,可直至出现平坦或倒置P波。性别差异:P波电压男性高于女性。男性直立P波发生率多于女性、女性正负双相P波发生率多于男性。V4R～V6R平坦及倒置P波的发生率女性多于男性(p<0.005)。从V1至V6R导联P波形态变化均直立及由直立向正负双相的男性多于女性。由正负双相向倒置及由直立、正负双相、平坦向倒置趋势变化的女性多于男性。结论正常人右胸导联心电图P波形态特征及性别差异,是常规18导联心电图应用必须掌握的一部分。
Objective To investigate the differences and changes of P wave morphology in right chest lead ECG between male and female patients. Methods The right chest lead ECG of 900 normal people was measured. The male and female were half pairs. The morphology and change of P wave were analyzed. Results right chest lead ECG P wave to biphasic positive and negative P wave. The incidence of upright P wave in lead V1 was significantly higher than that of positive and negative biphasic P wave (p <0.01). The incidence of upright P waves decreased from V1 to V6R, and the incidence of flat and inverted P wave increased from positive to negative in the order of V4R. From V1 to V6RP waveform morphological changes were all upright, both positive and negative biphasic and upright to the majority of positive and negative biphasic. The amplitudes of upright P waves and the positive and negative phases of positive and negative biphasic P waves decrease and then decrease in turn, and the amplitudes of negative waves increase and broaden in sequence until the flat or inverted P waves appear. Gender differences: P wave voltage is higher in males than females. The incidence of male P wave is higher than that of female, and the incidence of positive and negative biphasic P wave is more than that of male. V4R ~ V6R flat and inverted P wave incidence of more women than men (p <0.005). From V1 to V6R leads P wave morphological changes were upright and from the vertical to the positive and negative biphasic male than female. By the positive and negative double-phase inversion and upright, positive and negative biphasic, flat to the inverted trend of change in women than men. Conclusion The morphological characteristics and gender differences of P waves of right chest lead ECG in normal subjects are part of the routine 18-lead electrocardiogram.