Abstract： Objective:To investigate the effects of microecological immune preparations combined with enteral nutrition support(EN)on intestinal microecology in elderly stroke patients.Methods:Seventy elderly stroke patients admitted to our hospital from January 2021 to December 2021 were selected as the study objects,and were divided into study group and control group by random number table method,with 35 patients in each group.The control group was given EN treatment,and the study group was given microecological immune preparation combined with EN treatment.The nutritional status,intestinal flora number and intestinal mucosal barrier indexes of the two groups were compared.Results:After treatment,the NRS-2002 score of the study group was lower than that of the control group,and the levels of albumin(ALB),hemoglobin(Hb)and prealbumin(PA)were higher than those of the control group(P<0.05).The number of intestinal lactobacillus and bifidobacterium in the study group was higher than that in the control group,and the number of enterobacterium and enterococcus was lower than that in the control group(P<0.05).Serum levels of D-lactic acid,endotoxin,diamine oxidase(DAO)and enteric fatty acid-binding protein(I-FABP)in the study group were lower than those in the control group(P<0.05).Conclusion:Microecological immune preparations combined with EN can effectively regulate the proportion of intestinal flora in elderly stroke patients,enhance intestinal mucosal barrier function,improve intestinal microecology,reduce the risk of malnutrition,and improve the nutritional status of patients.