Intestinal flora and T helper 17/regulatory T cell cytokines in elderly patients with acute exacerbation of chronic obstructive pulmonary disease complicated with type Ⅱ respiratory failure

Zhang Wenhao; Li Jing; Liu Ying

doi:10.3760/j.issn.1673-4777.2026.05.007

Abstract：Objective To investigate the effects of enteral nutrition suspension combined with bifidobacterium triple viable capsules on intestinal flora and T helper cell 17/regulatory T cell(Th17/Treg)cytokines in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with type Ⅱ respiratory failure.Methods A total of 205 elderly patients with AECOPD complicated with type Ⅱ respiratory failure admitted to Nanjing Hospital Affiliated to Nanjing Medical University from August 2023 to March 2025 were enrolled.They were divided into control group(102 cases)and treatment group(103 cases)by random envelope method.The control group received early enteral nutrition,while the treatment group was additionally given bifidobacterium triple viable capsules on the basis of early enteral nutrition.Both groups were treated continuously for 10 d.The clinical efficacy of the two groups was observed,and the nutritional indicators,intestinal flora,serum Th17/Treg cytokines and adverse reactions before and after treatment were compared.Results The total clinical effective rate of the treatment group was significantly higher than that of the control group[95.1％(98/103)vs 85.3％(87/102)](P＜0.05).In terms of nutritional indicators,the levels of albumin,total protein and hemoglobin in both groups were significantly increased after treatment compared with those before treatment,and the levels in the treatment group were significantly higher than those in the control group(all P＜0.05).Intestinal flora analysis showed that compared with before treatment,the abundance of beneficial bacteria(Bifidobacterium,Lactobacillus acidophilus)in both groups was significantly increased after treatment,while the abundance of harmful bacteria(Escherichia coli,Enterococcus)showed an opposite change;comparison between groups further confirmed that the treatment group was significantly better than the control group in optimizing flora structure(all P＜0.05).Compared with before treatment,the serum levels of interleukin-17(IL-17)and tumor necrosis factor-α(TNF-α)in both groups were significantly decreased after treatment,while the levels of IL-10 and IL-35 were significantly increased.Meanwhile,the serum levels of IL-17 and TNF-α in the treatment group were significantly lower than those in the control group,and the levels of IL-10 and IL-35 were significantly higher than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P＞0.05).Conclusion Early enteral nutrition combined with bifidobacterium triple viable capsules can effectively improve the clinical efficacy of elderly patients with AECOPD complicated with type Ⅱ respiratory failure,improve nutritional indicators and intestinal flora,regulate Th17/Treg cytokines,with good safety.