Objective

There is scarce data on B cell lymphoma 2 (Bcl2), a member of the Bcl-2 family of antiapoptotic molecules of the intrinsic apoptosis pathway, in patients with spontaneous intracerebral hemorrhage (SIH). In one study, higher serum Bcl2 levels were found in patients with SIH than in healthy subjects. Thus, the objective of our study was to compare serum Bcl2 levels in surviving and non-surviving SIH patients.

Methods

Patients with severe supratentorial SIH (defined as Glasgow Coma Scale < 9) admitted from the Intensive Care Units of five Spanish hospitals were included in this observational and prospective study. Serum levels of Bcl2L were determined at the time of diagnosis. Thirty-day mortality was the end-point study.

Results

Non-surviving (n = 38) compared to surviving patients (n = 41) had higher intracerebral hemorrhage (ICH) score (p = 0.001), midline shift (p = 0.003), and serum Bcl2 levels (p < 0.001). In addition, non-surviving compared to surviving patients had lower early hematoma evacuation rate (p = 0.03). We found 77% area under curve in mortality prediction for serum Bcl2 levels (95% CI = 0.66–88%; p < 0.001). Patients showing serum Bcl2 levels > 16.5 ng/mL had higher risk of death according to analysis of Kaplan-Meier (HR = 5.2; 95% CI = 2.5–10.6; p < 0.001). An association, after control for ICH score, midline shift, and early hematoma evacuation, was found between serum Bcl2 levels and 30-day mortality (OR = 1.090; 95% CI = 1.030–1.154; p = 0.003) in the multiple logistic regression.

Conclusions

As far as we know, our study is the first one reporting higher serum Bcl2 levels in non-surviving than in surviving SIH patients and the association between serum Bcl2 levels and SIH mortality.

中文翻译：

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自发性脑出血患者血清B细胞淋巴瘤2浓度和死亡率

客观的

在自发性脑出血 (SIH) 患者中，关于 B 细胞淋巴瘤 2 (Bcl2) 的数据稀少，Bcl-2 是内在凋亡途径的抗凋亡分子 Bcl-2 家族的成员。在一项研究中，发现 SIH 患者的血清 Bcl2 水平高于健康受试者。因此，我们研究的目的是比较存活和非存活 SIH 患者的血清 Bcl2 水平。

方法

这项观察性和前瞻性研究纳入了从西班牙五家医院的重症监护病房收治的严重幕上 SIH（定义为格拉斯哥昏迷评分 < 9）的患者。在诊断时测定血清 Bcl2L 水平。30天死亡率是终点研究。

结果

与存活患者 ( n = 41  ) 相比，未存活患者( n  = 38) 的脑出血 (ICH) 评分 ( p  = 0.001)、中线偏移 ( p  = 0.003) 和血清 Bcl2 水平 ( p  < 0.001) 更高。此外，与存活患者相比，未存活患者的早期血肿清除率较低（p  = 0.03）。我们发现血清 Bcl2 水平的死亡率预测曲线下面积为 77%（95% CI = 0.66-88%；p  < 0.001）。根据 Kaplan-Meier 分析，血清 Bcl2 水平 > 16.5 ng/mL 的患者死亡风险较高（HR = 5.2；95% CI = 2.5–10.6；p < 0.001)。 在控制 ICH 评分、中线移位和早期血肿清除后，在多元逻辑回归中发现血清 Bcl2 水平与 30 天死亡率之间存在关联（OR = 1.090；95% CI = 1.030-1.154；p = 0.003） .

结论

据我们所知，我们的研究是第一个报告非存活患者的血清 Bcl2 水平高于存活的 SIH 患者以及血清 Bcl2 水平与 SIH 死亡率之间的关联。