Abstract: Objective The aim of this study was investigate the clinical application of blood red blood cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) in evaluating liver damage in patients with primary biliary cholangitis (PBC). Methods 93 PBC patients, including 30 with severe(stage Ⅲ) and 63 with mild (stage I /Ⅱ) liver injury, were enrolled in our hospital between March 2017 and December 2019. The RDW and NLR were obtained and calculated routinely. The univariate and multivariate Logistic regression analysis was performed to predict the risk factors for severe liver injuries, and the diagnostic efficacy of any parameter was evaluated by area under the receiver operating characteristic curve (AUC). Results The RDW and NLR in patients with severe liver injury were significantly higher than those in patients with mild liver injury [(15.8±3.2)% vs. 13.3±2.9)%, and (2.1±0.4) vs. (1.5±0.3), respectively, P<0.05]; the percentages of alcohol hobby (33.3% vs. 7.9%), serum GGT level [(395.3±6.5)U/L vs. (189.2±6.1)U/L], serum ALP level [(352.1±49.2)U/L vs. (281.0±46.9)U/L], the RDW≥14.8%(70.0% vs. 46.0%) and the NLR≥1.8(76.7% vsl 41.3%)in patients with severe liver injury were significantly higher than in patients with mild liver injury (all P<0.05); the multivariate Logistic regression analysis showed that the alcohol intake [OR(95%CI):1.8(1.1-2.9)], GGT≥293.1 U/L[OR(95%CI):1.7(1.2-2.5)], ALP≥327.6 U/L[OR(95%CI):1.9(1.2-2.8)], the RDW≥14.8%[OR(95%CI):1.9(1.2-2.8)] and NLR≥1.8[OR(95%CI):1.7(1.3-2.2)] were the independent risk factors for PBC patients with severe liver injury; the AUC was 0.854, with the sensitivity of 86.7% and the specificity of 71.4% when the RDW and NLR combination (RDW=14.8% and NLR=1.8 were set as the cut-off-value) was applied to predict severe liver injury in patients with PBC. Conclusion The NLR and RDW are promising index in predicting liver damage in patients with PBC, which is easily obtained, and needs further clinical investigation.

Key words: Primary biliary cholangitis, Red blood cell distribution width, Neutrophil to lymphocyte ratio, Liver damage, Prediction