〔Abstract〕 Objective To investigate the predictive value of platelet volume distribution width(PDW), mean platelet volume(MPV), and D-dimer(D-D) on early shunt dysfunction in patients with decompensated cirrhosis treated with transjugular intrahepatic portosystemic shunt(TIPS). Methods A total of 28 patients with decompensated cirrhosis who developed shunt dysfunction within 6 months after TIPS were selected as the case group, and a 1 ∶2 matched control study was conducted. 56 patients matched by age(±2) and gender who did not develop shunt dysfunction within 6 months after TIPS were selected as the control group. Spss23.00 software was used to conduct univariate analysis to obtain statistically significant variables, and then conditional Logistic regression analysis was conducted with paired design, withP<0.05 being statistically significant. Results Patients with a history of splenectomy, portal vein thrombosis, and those with poor liver function grade were more likely to have functional dysfunction after TIPS. Platelet count(PLT), platelet volume distribution width(PDW), mean platelet volume(MPV), D-dimer(D-D) and Fibrinogen monomer(FDPI) had statistically significant differences between the case group and the control group. The values of D-D、PDW、MPV and FDPI in the case group were higher than those in the control group, while the value of PLT in the case group was lower than that in the control group. TheORvalues of PDW, MPV and D-D were 2.164, 3.826 and 1.382, respectively. ROC analysis results showed that the areas under PDW, MPV and D-D curves were 0.746, 0.773 and 0.690, respectively. Conclusion Compared with ultrasound, D-D, PLT and PDW could predict shunt dysfunction earlier after TIPS. Patients with normal shunt function indicated by color Doppler ultrasonography in postoperative follow-up of TIPS should be closely observed for indicators such as D-D, PLT and PDW, which is of important significance for clinical indication of shunt dysfunction in TIPS.