如果没有低估,全球大约有1.4-2.5亿人口患有淋巴水肿。[3]Slavin SA, Greene AK, Borud LJ. Lymphedema. In: Weinzweig J, ed. Plastic surgery secrets plus. 2nd ed. Philadelphia, PA: Mosby; 2009.尽管近期有所改善,估计超过 1600 万淋巴水肿病例因线虫感染(丝虫病)导致。[5]Ramaiah KD, Ottesen EA. Progress and impact of 13 years of the global programme to eliminate lymphatic filariasis on reducing the burden of filarial disease. PLoS Negl Trop Dis. 2014;8:e3319.http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003319http://www.ncbi.nlm.nih.gov/pubmed/25412180?tool=bestpractice.com
淋巴水肿的全球负担不明。儿童中的原发性淋巴水肿罕见;估计患病率为 1.15 例/10 万人。[6]Smeltzer DM, Stickler GB, Schirger A. Primary lymphedema in children and adolescents: a follow-up study and review. Pediatrics. 1985;76:206-218.http://www.ncbi.nlm.nih.gov/pubmed/4022694?tool=bestpractice.com男性和女性受影响几率相同;男性主要在婴儿期发病,而女性通常在青春期发病。[1]Schook CC, Mulliken JB, Fishman SJ, et al. Primary lymphedema: clinical features and management in 138 pediatric patients. Plast Reconstr Surg. 2011;127:2419-2431.http://www.ncbi.nlm.nih.gov/pubmed/21617474?tool=bestpractice.com迟发性淋巴水肿的发生难以辨别,因为它与继发性淋巴水肿有时间重叠。[7]Williams AF, Franks PJ, Moffatt CJ. Lymphoedema: estimating the size of the problem. Palliat Med. 2005;19:300-313.http://www.ncbi.nlm.nih.gov/pubmed/15984502?tool=bestpractice.com
大部分发生淋巴水肿的患者有恶性疾病病史。乳腺癌治疗后,淋巴水肿风险与治疗程度和癌症分期成比例。[7]Williams AF, Franks PJ, Moffatt CJ. Lymphoedema: estimating the size of the problem. Palliat Med. 2005;19:300-313.http://www.ncbi.nlm.nih.gov/pubmed/15984502?tool=bestpractice.com[8]Rockson SG, Rivera KK. Estimating the population burden of lymphedema. Ann NY Acad Sci. 2008;1131:147-154.http://www.ncbi.nlm.nih.gov/pubmed/18519968?tool=bestpractice.com在 936 例乳腺癌女性患者中,前哨淋巴结活检 5 年后的淋巴水肿患病率为 5%,而在接受前哨淋巴结活检之后又接受腋窝淋巴结清除术的女性患者中,淋巴水肿患病率为 16%。[9]McLaughlin SA, Wright MJ, Morris KT, et al. Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: objective measurements. J Clin Oncol. 2008;26:5213-5219.http://www.ncbi.nlm.nih.gov/pubmed/18838709?tool=bestpractice.com