Objective  To investigate the effect of nucleotide drugs on clinical features, progression and prognosis of patients with acute on chronic hepatic failure.

  Methods  Totally 108 patients with acute on chronic hepatic failure were selected and randomly divided into treatment group and control group, with 54 cases in each group. The control group was treated with routine medical treatment, while the treatment group was treated with nucleotide drugs orally on the basis of the control group. Peripheral blood cell indexes (white blood cell count, neutrophil, platelet, hemoglobin) and coagulation function were compared between the two groups before and after treatment.Logistic regression analysis was applied in age, ascites, hepatic encephalopathy, baseline HBV-DNA, alanine aminotransferase, aspartate aminotransferase and model for end-stage liverdisease (MELD) to explore the influencing factors of prognosis.

  Results  After treatment, peripheral blood leukocytes and neutrophils in both groups were significantly lower than those before treatment, and those in the treatment group was significantly better than the control group (P < 0.05). After treatment, platelet and hemoglobin levels in both groups were significantly higher than those before treatment, and those in the treatment group were significantly better than the control group (P < 0.05).After treatment, the prothrombin time and international standardized ratio in the treatment group were significantly lower than those in the control group, and the fibrinogen content was significantlyhigher than that in the control group (P < 0.05). Ascites, hepatic encephalopathy and MELD score show significant influence on the prognosis and survival of patients.

  Conclusion  Ascites, hepatic encephalopathy and MELD score show significant influence on prognosis and survival of patients.Nucleotide drugs can effectively improve the level of peripheralblood cell indexes and cell coagulation function in patients with acute on chronic hepatic failure.