Objective To evaluate the clinical efficacy of glucocorticoids combined with antiviral therapy in the treatment of patients with early stage of chronic severe hepatitis B.Methods 63 patients with early stage of chronic severe hepatitis B were enrolled.33 patients in treatment group received the ordinary treatment plus dexamethasone and lamivudine/entecavir.The changes of clinical symptoms, the serum total bilirubin (TBil) , the prothrombin activities (PTA) and the serum HBVDNA levels in the 2 groups were observed before and after therapy.The side effect and complication of each group were monitored.Results After 8 weeks treatment, compared with control group, the treatment group can significantly decrease the level of TBil (P<0.05) , increase PTA level (P<0.05) , and improve the clinical symptoms.After 4 weeks treatment, the negativity of serum PCR HBVDNA was 87.1% in treatment group, it was 85.1% in control group (P>0.05) .The failure rate of the treatment group and the control group are 15.2% (5/33) and 40.0% (12/30) (P<0.05) . The complications of hepatorenal syndrome (HRS) and hepatic encephalopathy (HE) occur in control group more than that in treatment group (P<0.05) .Conclusion Glucocorticoids combined with antiviral therapy have a remarkable effect on early stage of chronic severe hepatitis B and both are very safe.
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