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1.
肝门阻断后细菌移位和门静脉血中内毒素变化的研究   总被引:1,自引:0,他引:1  
目的 研究肝门部血流阻断后肠粘膜损害所致细菌移位及门静脉血中内毒素的变化。方法 采用兔动物模型,在无菌条件下机械性阻断肝十二指肠韧带,观察阻断后15,20,30min和60min时门静脉血中内毒素值和肠系膜淋巴结细菌培养阳性数。结果 实验组肝门阻断后门静脉血内毒素值和细菌培养阳性数明显高于对照组(P<0.01),且随阻断时间延长加重。结论 缺血、缺氧是肠粘膜屏障损害的直接原因,深入对肠粘膜屏障功能保护的研究将有利于指导临床工作。  相似文献   

2.
目的 研究生长激素对肠缺血—再灌注肠粘膜屏障的保护作用。方法 观察小肠缺血—再灌注24h小肠粘膜形态学,腹腔淋巴结细菌培养、门静脉内毒素水平、小肠粘膜细胞凋亡的改变及生长激素对其改变的影响。结果 小肠缺血—再灌注24h,小肠粘膜细胞凋亡增加,绒毛高度和数量显著降低,门静脉内毒素水平升高,腹腔淋巴结细菌培养阳性升高;生长激素能显著改善上述改变。结论 生长激素对肠缺血—再灌注肠粘膜屏障具有明显保护作用。  相似文献   

3.
猪门静脉血流阻断后细菌及内毒素移位的研究   总被引:3,自引:0,他引:3  
目的:研究猪门静脉血流阻断后细菌及内毒素移位,进一步了解门静脉系统淤血对肠粘膜屏障功能的影响。方法:将健康荣昌种猪随机分为假手术组(SO)、门静脉阻断45min(PVC-45')、60min(PVC-60')组,在阻断前、复流前、复流后1h时相点,取肠系膜淋巴结作细菌培养及取门静血作内毒素检测。结果:PCV-45'、60’组细菌培养及LPS均明显高于未阻断组(SO组)(P<0.05)。结论:门静脉阻断后引起的肠粘膜缺血/缺氧,是肠粘膜屏粘膜障功能障碍的直接原因,细菌移位和内毒素变化是肠粘膜屏障功能受损的表现。  相似文献   

4.
目的探讨参附注射液(SF)对大鼠胰腺移植受体肠粘膜屏障的保护作用及机制。方法24只糖尿病大鼠随机分为缺血再灌注组(IR组,n=12),参附注射液预处理组(SF组,n=12),12只正常大鼠为对照组,IR组和SF组大鼠均接受胰腺移植,再灌注后5d检测小肠通透性和吸收功能,检测血清TNF-α、NO、SOD和淀粉酶活性,取受体空肠粘膜组织检测小肠粘膜粘膜湿重、微绒毛高度及宽度、MDA含量及MPO活性,同时取肠系膜静脉血、肠系膜淋巴结、肝及脾组织进行细菌培养,观察细菌易位情况。结果再灌注后SF组血清TNF-α含量(P<0.01)、淀粉酶活性(P<0.01)、MDA含量(P<0.01)、MPO活性(P<0.01)、小肠通透性(P<0.01)、细菌易位率(P<0.01)和小肠粘膜损伤程度均低于IR组;血清NO和SOD含量、小肠吸收功能均高于IR组(P<0.01)。结论SF预处理可保护大鼠胰腺移植受体小肠肠粘膜屏障,降低细菌易位率,机制可能与降低胰酶活性、减少TNF-α生成、减轻PMNs粘附与聚集、增加NO和SOD含量有关。  相似文献   

5.
清热解毒方剂对腹腔感染大鼠肠黏膜屏障功能的影响   总被引:2,自引:1,他引:1  
目的:观察腹腔感染状态下大鼠肠黏膜形态学和通透性的变化,观察肠源性内毒素体内移位途径,探讨清热解毒方剂肠屏障保护作用的机制.方法:采用人工胃液联合大肠杆菌腹腔内注射的方法建立大鼠腹腔感染模型.将Wistar大鼠分为3组:正常对照组(C组)、模型组(M组)、清热解毒方剂组(QRJD组),分别观察造模后6 h,24 h,72 h回肠的病理学改变以及尿液中乳果糖与甘露醇的比值(L/M)的变化.采用荧光化学发光法检测门静脉、乳糜管淋巴液、腹主动脉血以及肠系膜淋巴结、肝、肺、肠、脾组织FITC-LPS荧光强度.结果:模型组肠黏膜损伤,尿液L/M显著升高,脏器组织中FITC-LPS含量由高至低为:肠系膜淋巴结、肺、肝、肠、脾,体液中FITC-LPS含量以乳糜管淋巴液含量最高.清热解毒方剂组上述指标较模型组明显改善.结论:清热解毒方剂可以显著减轻大鼠腹腔感染所致肠黏膜损伤,改善肠黏膜通透性,减少肠源性内毒素移位,改善肠道屏障功能.  相似文献   

6.
目的观察肠缺血再灌注时门、体循环 D-乳酸的动态变化及其与肠粘膜损害的相关性。方法采用大鼠肠系膜上动脉阻断75分钟后松夹进行重灌注的模型,分别于术前,阻断末,松夹后0.5,2,6小时活杀动物,观察门静脉和体循环 D-乳酸水平、血浆内毒素含量及小肠病理形态学改变。结果肠缺血75分钟后大鼠门静脉 D-乳酸水平较伤前值显著上升(P<0.05),再灌注后呈进一步持续升高趋势。外周血 D-乳酸的改变与门脉血基本一致,各时相点与门脉血含量相比差异无显著意义(P>0.05)。相关分析结果显示,门静脉血浆 D-乳酸含量与肠粘膜损伤评分值呈显著正相关(r=0.415,P<0.01)。与此同时,大鼠肠缺血75分钟门静脉内毒素含量迅速上升,再灌注后2小时达峰值。结论急性肠缺血再灌注可致肠粘膜屏障破坏。使门、体循环 D-乳酸水平显著升高,其含量与小肠粘膜损害密切相关。因此,D-乳酸可作为新的血浆标志物应用于急性肠粘膜损害的早期诊断。  相似文献   

7.
目的 :探讨银杏叶提取物(EGb)对胰腺移植受体大鼠肠黏膜屏障的保护作用及其机制。方法 :12只正常SD大鼠为对照组;糖尿病大鼠随机分为胰腺移植组(PT组, n =12)及银杏叶提取物预处理胰腺移植组(EGb组, n =12),大鼠均接受同系胰腺移植。EGb组于移植前1d和30min予受体静脉注射EGb (1.5mL/kg)。移植术后5 d测定小肠通透性和吸收功能,检测血清TNF-α,NO,SOD和淀粉酶活性。取受体回肠黏膜组织测定小肠黏膜湿重、微绒毛厚度及宽度、MDA含量及MPO活性。同时取肠系膜静脉血、肠系膜淋巴结、肝及脾组织行细菌培养,观察细菌易位情况。结果 :EGb组血清TNF-α含量( P <0.01)、淀粉酶活性( P <0.01)、MDA含量( P <0.05)、MPO活性( P <0.05)、小肠通透性( P <0.01)、细菌易位率( P <0.01)和小肠黏膜损伤程度均低于PT组;血清NO和SOD含量、小肠吸收功能均高于PT组( P <0.01)。结论 :EGb预处理可保护胰腺移植受体大鼠小肠肠黏膜屏障,降低细菌易位率,机制可能与抗氧化、清除自由基、减少TNF-α生成、减轻嗜中性粒细胞黏附与聚集、增加内源性NO的生成有关。  相似文献   

8.
目的探讨参附注射液(SF)对大鼠胰腺移植受体肠粘膜屏障的保护作用及机制。方法24只糖尿病大鼠随机分为缺血再灌注组(IR组。n=12),参附注射液预处理组(SF组.n=12),12只正常大鼠为对照组,IR组和SF组大鼠均接受胰腺移植,再灌注后5d检测小肠通透性和吸收功能,检测血清TNF-α、NO、SOD和淀粉酶活性,取受体空肠粘膜组织检测小肠粘膜粘膜湿重、微绒毛高度及宽度、MDA含量及MPO活性,同时取肠系膜静脉血、肠系膜淋巴结、肝及脾组织进行细菌培养,观察细菌易位情况。结果再灌注后SF组血清TNF—α含量(P〈0.01)、淀粉酶活性(P〈0.01)、MDA含量(P〈0.01)、MPO活性(P〈0.01)、小肠通透性(P〈0.01)、细菌易位率(P〈0.01)和小肠粘膜损伤程度均低于IR组;血清NO和SOD含量、小肠吸收功能均高于IR组(P〈0.01)。结论SF预处理可保护大鼠胰腺移植受体小肠肠粘膜屏障,降低细菌易位率,机制可能与降低胰酶活性、减少TNF—α生成、减轻PMNs粘附与聚集、增加NO和SOD含量有关。  相似文献   

9.
目的探讨选择性肠道去污染对肝硬化大鼠肝门阻断后肠道细菌移位、内毒素血症的效果。方法将制成肝硬化模型的60只雄性SD大鼠随机分为假手术组、肝门阻断30rain组(阻断组)及通过选择性肠道去污染预处理组(预处理组),各20只。在实验术后30min及24h时分别取肠系膜淋巴结、肝、肺及门、腔静脉血作细菌培养,并取门、腔静脉血作内毒素检测。结果阻断组大鼠手术后30min即出现门、腔静脉血内毒素浓度升高(P〈0.01),在手术24h后升高更明显。并在术后24h肠系膜淋巴结、肝组织及门、腔静脉血细菌培养出现阳性,主要为大肠杆菌。预处理组大鼠无论是手术30min还是24h后,门、腔静脉内毒素水平升高均不明显,较阻断组明显降低(P〈0.01),肠道外组织及门、腔静脉血细菌培养阳性率也明显降低。结论肝硬化大鼠肝门阻断30min后早期即可出现内毒素血症,并于手术24h后出现明显肠道细菌移位。选择性肠道去污染能减少肝硬化大鼠肝门阻断后肠道细菌移位及内毒素血症的发生。  相似文献   

10.
火器多发伤时骨折早期固定减轻肠道屏障功能损害的研究   总被引:2,自引:0,他引:2  
Li ZL  Yang XD  Lu LR  Yu Y  Yang YX  Zhang YD 《中华外科杂志》2003,41(8):620-622
目的 探讨多发伤时骨折早期固定能否减轻肠道屏障功能的损害。 方法  12只小型猪制作火器多发伤模型 ,即颅骨切线伤加双股骨干粉碎骨折 ,损伤严重度评分≥ 16后 ,随机分为对照组 (n =6 )和骨折内固定组 (n =6 )。伤前及伤后 6、12、2 4、4 8和 72h ,采用酶学分光光度法检测血浆D 乳酸水平 ,观察肠道通透性的变化 ;分光光度法检测血浆和小肠组织中二胺氧化酶 (DAO)含量 ;偶氮显色法鲎试验定量测定门静脉血浆内毒素浓度 ;常规方法做门静脉血细菌培养。 结果 对照组伤后血浆D 乳酸和DAO水平显著升高 ,并维持高水平到 72h ;小肠组织DAO含量明显降低 ,门静脉血浆内毒素水平明显升高 ,门静脉血细菌培养阳性率为 6 3 3%。骨折内固定组伤后 6和 12h血浆D 乳酸、DAO和内毒素水平也明显升高 ,但 2 4或 4 8h以后明显回落 ,72h与对照组相比差异有显著意义(P <0 0 5 ) ,细菌培养阳性率也低 (30 0 % ,P <0 0 5 )。 结论 多发伤后出现肠道通透性增高 ,肠黏膜完整性受损 ,有细菌、内毒素移位发生。骨折早期内固定可以减轻肠道屏障功能的损害 ,减少肠源性感染的机会。  相似文献   

11.
12.
Protective effects of steroids against ischemia-reperfusion (I/R) injury are well known, but there is little information about the influence of temporary inflow occlusion on intestinal barrier function or bacterial translocation. The aim of this experimental study was to investigate the effects on liver, kidney, spleen, ileal mitochondrial stress enzymes, and bacterial translocation of methylprednisolone (MP) in rats undergoing temporary liver inflow occlusion. Twenty-seven pathogen-free Wistar albino rats were randomized into three groups: group A: I/R (n = 10); group B: I/R + MP (n = 10); and group C: sham (n = 7). Rats in groups A and B were subjected to 20 minutes of portal vein and hepatic artery occlusion with 3 mg/kg MP injected into group B animals intraperitoneally during the occlusion. Twenty-two hours later, all rats were sacrificed to measure mitochondrial oxidative stress enzymes in liver, kidney, spleen, and ileum. We evaluated intestinal bacterial counts, intestinal mucosal histopathology, bacterial translocation to mesenteric lymph nodes (MLN), liver, spleen, and kidney. Decreased levels of malondialdehyde and increased levels of glutathione were observed in all examined tissues of group B compared to those of group A rats. Statistically significant increases in the intestinal counts of Klebsiella spp and Proteus spp and of bacterial translocation to liver, kidney, spleen, and MLN were measured in group B with respect to group A.  相似文献   

13.
目的 观察急性坏死性胰腺炎(ANP)时肠粘膜屏障的改变和肠源性细菌和内毒素移位。方法 将Wistar大鼠随机分为正常对照组(n=6)、假手术组(n=30)和ANP组(n=39)。采用人工胆汁胰管逆行灌注法制作ANP模型。观察胰腺、小肠病理改变和小肠粘膜上皮细胞间紧密连接(冷冻蚀刻电镜)变化。动态测定血浆D-乳酸、内毒素水平,以及腹腔脏器细菌移位率。结果 ANP后小肠粘膜损伤,皮皮细胞间紧密连接破坏甚至消失,血浆D-乳酸水平上升,发病早期即出现内毒素血症;ANP发生后72h脏器细菌移位率达到59.5%。结论 ANP早期肠粘膜屏障功能受损。导致肠道细菌和内毒素移位,成为全身炎症反应和胰腺继发感染的根源。  相似文献   

14.
BACKGROUND: Intraoperative occlusion of the hepatoduodenal ligament (Pringle manoeuvre (Pm)) is often employed for the reduction of blood loss during liver surgery. No data exist to date on the effects of Pm on mucosal barrier dysfunction, systemic bacterial translocation (BT), endotoxaemia and apoptosis. MATERIALS AND METHODS: Sixty-five male Wistar rats in three groups: I (n=25) controls, II (n=20) sham operation, III (n=20) occlusion of the hepatoduodenal ligament (Pm). Tissue samples from mesenteric lymph nodes (MLNs), liver, lungs and spleen were analysed after 30 min and at 24 h. Endotoxin was measured in portal and aortic blood and routine haematological and biochemical parameters were measured before and after Pm. RESULTS: No differences were found in the blood parameters before and after Pm, but a significant increase in contaminated MLNs and liver was noted. All cultured bacteria were enteric in origin. Portal and aortic endotoxin were significantly increased. Overall the ileal architecture remained intact in all specimens studied and no significant pathology was observed. The ABC increased after Pm significantly (P<0.01). CONCLUSION: Normothermic Pm of 30 min duration results in immediate and delayed gut barrier failure by significantly increasing BT and endotoxaemia which might be attributed to portal stasis leading to intestinal congestion as well as temporary liver ischaemia. Apoptosis increased significantly 30 min after performing the Pm.  相似文献   

15.
目的 探讨磷脂酶A2(PLA2)抑制剂喹吖因对大鼠肠道缺血再灌注(gut ischemia reperfusion,GIR)损伤后肠源性细菌/内毒素移位的影响。方法 42只wistar大鼠随机分为正常组(6只)和GIR损伤组(36只)。GIR损伤组又分为GIR损伤对照组、再灌注后3h喹吖用药组和12h喹吖用药组,每组12只。取正常对照组、GIR损伤对照组及用药组48、72h门、腔静脉血测定内毒素含量、腔静脉血浆TNFα含量和肠系膜淋巴结、肝、肺、肾等肠道外器官组织进行细菌培养。结果 早期应用喹吖因,无论是GIR损伤后3h用药组还是12h用药组,均可明显降低GIR损伤后血浆内毒素和TNFα水平(P<0.01);显降低GIR损伤后肠系膜淋巴结和肺、肝、肾组织器官中的细菌移位发生率(P<0.05-0.01)。结论 GIR损伤后早期应用喹吖因可显地降低肠源性细菌/内毒素移位,减轻促炎性介质和细菌因子的释放,减轻肠道外脏器损伤。  相似文献   

16.
Wang Z  Xiao G  Yao Y  Guo S  Lu K  Sheng Z 《The Journal of trauma》2006,61(3):650-657
BACKGROUND: Early multiple organ dysfunction syndrome appears to be facilitated with bacterial translocation in severe burn injury, yet the mechanisms of bacterial translocation remain in dispute. The aim of this study was to characterize the potential role of intestinal bifidobacteria in the pathogenesis of gut-derived bacterial translocation after burns and to analyze the effects of bifidobacterial supplement on gut barrier function. METHODS: Wistar rats were randomly divided into burn group (Burn, n = 60), sham burn group (SB, n = 10) in experiment 1, and burn + saline group (BS, n = 30), burn + bifidobacteria group (BB, n = 30), and sham-burn + saline group (SS, n = 30) in experiment 2. Animals in BB group were fed bifidobacterial preparation (5 x 10(9) CFU/mL) after burns, 1.5 mL, twice daily. Animals in BS and SS were fed saline. Samples were taken on postburn days 1, 3, and 5. The incidence of bacterial translocation and counts of Bifidobacterium, fungi and Escherichia coli in gut mucosa, as well as the sIgA levels in mucus of the small intestine were determined. The positive sIgA expression in lamina propria and ileum mucosal injury were evaluated light microscopically by blinded examiners. RESULTS: The incidence of bacterial translocation was increased after burns, which was accompanied by significant decrease in number of bifidobacteria but significant increase in E. coli and fungi in gut mucosa, and elevation of levels of plasma endotoxin and IL-6 (p < 0.001). The incidence of bacterial translocation was markedly reduced after 3- and 5-day supplementation of bifidobacteria compared with control group (p < 0.05). The counts of mucosal bifidobacteria were increased by 4- to 40-fold, whereas E. coli and fungi were decreased by 2- to 30-fold and 10- to 150-fold, respectively, after bifidobacterial supplementation. The damage of mucosa tended to be less pronounced after 3-day bifidobacteria-supplemented formula compared with control group (grade 2 [0-6] versus grade 4 [3-6], p < 0.05). Moreover, the expression and release of sIgA was markedly augmented after 3-days of bifidobacteria-supplementation formula and it returned to normal range on postburn day 5. CONCLUSIONS: The decrease in counts and proportion of bifidobacteria to other flora in gut may play an important role in the development of bacterial translocation after thermal injury. Supplementation of exogenous bifidobacteria could improve gut barrier function, and attenuate bacterial/endotoxin translocation secondary to major burns.  相似文献   

17.
Early multiple organ dysfunction syndrome appears to be facilitated with bacterial translocation in severely burn injury, yet the mechanisms of bacterial translocation remains in dispute. The aim of this study was to investigate the potential role of intestinal bifidobacteria in the pathogenesis of gut-derived bacteria/endotoxin translocation following burns and the effects of bifidobacterial supplement on gut barrier. Methods: Wistar rats were randomly divided into burn group (Burn, n=60),sham burn group (SB, n=10) in experiment Ⅰ , and burn + saline group (BS, n=30), burn + bifidobacteria group (BB, n=30), and sham-burn + saline group (SS, n= 10) in experiment Ⅱ. Animals in BB group were fed bifidobacterial preparation (5 × 109 CFU/ml) after burns, 1.5ml,twice daily. Animals in BS and SS were fed saline. Samples were taken on days 1, 3, and 5 in burn groups, and on day 3 in sham-burn groups. The incidence of bacteria/endotoxin translocation and counts of Bifidobacterium, Fungi and Escherichia coli in gut mucosa were determined with standard methods. The levels of sIgA in mucus of small intestine were measured by RIA. The positive sIgA expression in lamina propria and ileum mucosal injury was evaluated light microscopically by blinded examiners. Results: Our results showed that the incidence of bacterial translocation was increased after burns, which was accompanied by significant decrease in number of bifidobacteria but significant increase in E. coli and fungi in gut mucosa, and elevation of levels of plasma endotoxin and IL-6 (P<0. 001).The incidence of bacterial translocation was markedly reduced after 3- and 5-day supplementation of bifidobacteria compared with control group (P<0.05). The counts of mucosal bifidobacteria were increased by 4- to 40-fold,while E. coli and fungi were decreased by 2- to 30-fold and 10- to 150-fold, respectively, after bifidobacterial supplementation in contrast to control group. The damage of mucosa tended to be less pronounced after 3-day bifidobacteria-supplemented formula compared with control group [grade 2(0-6) vs. grade 4(3-6), P<0.05]. Moreover, the expression and release of sIgA was markedly augmented after 3-day bifidobacteria-supplementation formula and it returned to normal range on day 5. Conclusion: The decrease in counts and proportion of bifidobacteria in mucous membrane flora may play an important role in the development of bacteria/endotoxin translocation following thermal injury. The supplement of exogenous bifidobacteria could per se improve gut barriers, and attenuate bacteria/endotoxin translocation secondary to major burns.  相似文献   

18.
目的探讨肠内肠外营养与经肠道补充益生菌对腹腔感染大鼠肠道微生态及肠屏障功能的影响。方法21只SD大鼠随机分为3组(每组7只),分别给予肠外营养(PN组)、肠外加肠内营养(PN加EN组)和肠外、肠内营养加益生菌(益生菌组)。3组营养供给为等热、等氮量。于第6天处死大鼠,取其盲肠内容物作厌氧菌培养,采用随机扩增多态性DNA技术作菌种DNA指纹图谱分析;采用免疫组织化学方法测定其末段回肠和结肠的跨膜结合蛋白及肠上皮浆细胞免疫球蛋白(IgA)表达水平;取腔静脉血及肺、肝、肠系膜淋巴组织匀浆后作细菌培养,测细菌易位率;采用鲎试剂法检测门静脉血内毒素含量。结果(1)益生菌组及PN加EN组各种菌种的数量均较PN组增多(P<0.05)。PN组细菌DNA指纹图谱条带明显减少,且出现明显异常条带,其他两组大鼠肠道内优势菌群的基因条带与正常大鼠具有较高的一致性。(2)PN加EN组和益生菌组小肠和结直肠跨膜结合蛋白及IgA表达明显高于PN组(P<0.05及P<0.01),且益生菌组跨膜结合蛋白的表达高于PN加EN组(P<0.05);PN加EN组的小肠和益生菌组结直肠IgA的表达明显高于PN组(P<0.01)。(3)PN加EN组和益生菌组血、肺、肝、肠系膜淋巴组织的细菌易位率和内毒素水平均低于PN组(P<0.05),前两组之间差异无统计学意义。结论益生菌联合EN能增加肠上皮跨膜结合蛋白IgA表达,改善肠道微生态,从而保护肠黏膜屏障、减少细菌易位。  相似文献   

19.
补充双歧杆菌可促进烫伤大鼠肠道分泌型sIgA合成与分泌   总被引:19,自引:1,他引:19  
目的 探讨严重烫伤后补充双歧杆菌与肠道sIgA合成、分泌的关系。  方法 Wistar大鼠随机分为烫伤对照组 (BC组 ,30只 )、烫伤治疗组 (BT组 ,30只 )、假伤组 (NC组 ,10只 )。BT组大鼠烫伤后灌胃双歧杆菌悬液 (5 0× 10 9CFU/ml) 1 5ml,2次 /d。观测大鼠细菌移位、肠黏膜菌群双歧杆菌量、肠道sIgA分泌和表达情况等。  结果  (1)伤后 3d ,BC组与BT组大鼠脏器细菌移位率分别为 4 2 %和 16 % (P =0 0 0 4 ) ;伤后 5d分别为 30 %和 8% (P =0 0 0 2 )。 (2 )伤后大鼠肠黏膜菌群中双歧杆菌减少 10~ 6 0倍 ,应用悬液后双歧杆菌明显增多。 (3)BC组大鼠肠黏液sIgA平均减少 30 % ,伤后 3d达最低 ;BT组 3d后基本恢复正常。伤后大鼠肠道sIgA表达减弱 ,补充双歧杆菌后sIgA表达显著增强。 (4)肠膜菌群中双歧杆菌量与肠黏液sIgA浓度呈显著正相关。  结论 大鼠严重烫伤后肠道sIgA产生明显受抑制 ,补充外源性双歧杆菌可促进肠道sIgA合成与分泌。  相似文献   

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