〔Abstract〕 Objective To study the changes of red blood cell distribution width(RDW) coefficient of variation(RDW-CV) and red blood cell distribution width standard deviation(RDW-SD) in patients with cirrhosis, and to explore the clinical significance of RDW-CV and RDW-SD in the differential diagnosis of compensatory and decompensated cirrhosis. Methods A total of 120 inpatients with cirrhosis diagnosed were selected, including 60 patients at the compensatory stage and 60 patients at the decompensation stage. The differences between RDW-CV and RDW-SD in patients at different stages were analyzed, and then the correlation of RDW-CV, RDW-SD with liver function indexes total protein(TP), albumin( ALB), alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL),alkaline phosphatase(ALP), γ-glutamyl transpeptidase(γ-GT) and inflammation indexes C-reaction protein(CRP) was discussed. Receiver operating characteristic curve(ROC) curve evaluated the specificity and sensitivity of RDW-CV and RDW-SD in the diagnosis of decompensated cirrhosis. Results Both RDW-CV and RDW-SD in the compensation period were lower than that in the decompensation period, while RDW-SD was more significant(P<0.001). In the compensatory stage of cirrhosis, RDW-SD and RDW-CV were negatively correlated with TP, in addition, RDW-SD was positively correlated with γ-GT; In the decompensated stage, RDW-SD was negatively correlated with ALB and positively correlated with TP, ALT, AST and TBIL. However, RDW-CV was also positively correlated with TP, ALT and TBIL, but the correlation was not as good as that of RDW-SD. CRP at decompensation was significantly positively correlated with RDW-SD, but not with RDW-CV. ROC curve analysis showed that the area under curve(AUC) of RDW-SD was 0.788, significantly higher than that of RDW-CV(0.648). Conclusion There are differences between RDW-CV and RDW-SD in different stages of cirrhosis, and the difference between RDW-SD is more significant, which has potential clinical value in differential diagnosis of decompens-ated cirrhosis.