[Abstrat]ObjectiveTo explore the related factors of HBV in the process of its chronic development,and to analyze their roles in the HBV chronic evolution and appraise their value of diagnosis,treatment and prognosis.MethodsEstablishing the detection Methods of miRNA(miR-191、-223、-222、-145、-21、-31、-126、-20a、-372)in peripheral blood mononuclear cell of HBV infected patients by xMAP bead-based suspension array,and use the technology to detect the expression of miRNA in different HBV infected periods.Using direct sequencing method to detect matching serum sample's HBV genotype and P gene area resistance locus mutation,and analyze gender,age,HBV genotype,HBV DNA load level,gene mutation,miRNA expression level,HBeAg state by Logistic regression analysis,dicuss which related with the disease outcomes after infected HBV and play great roles in the chronic evolution.ResultsHBV genotype C,the continuous high level expression of DNA loads,miR-20a expression,miR-126 and miR-223 expression were influence factors in progress of chronic hepatitis B(P<0.05),while the HBeAg status,natural occurrence of drug resistance related locus mutation,age,gender had no statistical significance(P>0.05)with the chronic progress.ConclusionC genotype,HBV DNA continuous high loads,high expression of miR-20a and low expression of miR-126,-223 maybe the related factors of hepatitis B chronic evolution,especially maybe the liver cancer risk factors.the conventional detect genotype,HBV DNA and miRNA for monitoring,prognosis and timely treatment to prevent chronic hepatitis B developed to LC and HCC provide information.%目的：探讨HBV感染引起的肝脏病变慢性化进展为慢性乙肝、肝硬化、肝癌之相关因素，分析各因素在肝脏病变慢性化演变过程中的作用及在诊断、治疗、判断预后中的应用价值。方法采用xMAP液态芯片技术定量检测HBV相关肝病标本中PBMCmiR-191、-223、-222、-145、-21、-31、-126、-20a、-372的表达水平；采用直接测序法检测相应血清标本HBV基因型及P基因区耐药位点突变；对HBV相关肝病慢性化进展的各可能相关因素包括性别、年龄、HBV基因型、HBV DNA载量水平、HBeAg状态、miRNA表达水平作多因素Logistic回归分析，探讨参与HBV感染引起的肝脏病变慢性化演变过程的相关因素。结果HBV C基因型、DNA载量持续高水平表达、miR-20a表达上调、miR-126及miR-223表达下调是在乙肝慢性化进展中有统计学意义的影响因素（P<0.05），而HBeAg状态、自然状态下发生的耐药相关位点突变，年龄、性别等因素差异无统计学意义（P>0.05）。结论C基因型，HBV DNA持续高载量以及miR-126、-223低表达，miR-20a高表达可能是导致乙肝慢性化的相关因素，尤其可能是肝癌发生的危险因子，常规检测基因型、HBV DNA及miRNA的定量检测可为监测病情、判断预后、及时治疗预防乙肝慢性化进展提供资料。
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