Abstract: Objective To investigate the efficacy and safety of glucocorticoid-decreasing-dose therapy in patients with hepatitis B-induced liver failure. Methods 64 patients with hepatitis B-induced acute-on-chronic liver failure at early stage were recruited in this study，and they were randomly divided into observation group and control group with 32 cases in each. The patients in control group were given the comprehensive treatment with hepatoprotective，antiviral，and supporting therapy，and the patients in observation group were intravenously given the treatment of methylprednisolone at dose of 1 mg?kg-1?d-1 at the base of comprehensive treatment. The mortality， complications，liver function index， serum HBV DNA levels were compared between the two groups after treatment. Results The occurrences of complications in observation and control groups were 12.5% and 25.0%，respectively（P<0.05）；the improvement of gastrointestinal symptoms took [（3.8±1.3） d and（15.5±1.8） d，P＜0.01]，the disappearance of jaundice took [（28.2±9.3）d and （41.5±10.3）d，P＜0.05]，and the hospital stay were [（41.5±4.3） d and（52.2±4.7）d，P＜0.05]，respectively in the two groups；the prothrombin time activity and serum albumin levels increased，and serum alanine aminotransferase and bilirubin levels decreased in observation group more obviously than in control（P<0.05）；serum HBV DNA levels were [（3.2±1.5）lg cps/ml and （3.3±1.3）lg cps/ml，P＞0.05]，and the fatality rates were 9.4% and 21.9% （P＜0.05） in the two groups. Conclusion The application of glucocorticoids in treatment of patients with liver failure can improve the therapeutic effect and reduce mortality with relative high security.

Key words: Liver failure, Hepatitis B, Glucocorticoid, Efficacy