Abstract： Objective This study utilized regadenoson stress D-SPECT to evaluate the impact of remote ischemic precondi-tioning combined with adenosine injection in patients undergoing percutaneous coronary intervention(PCI)using D-SPECT imaging.Methods Three hundred patients requiring coronary angiography and stent implantation were randomly assigned into two groups utilizing the random number table method.The conventional treatment group(150 patients)and the experimental group(150 patients)received standard treatment for coronary heart disease PCI.The experimental group underwent two sessions of remote ischemic precon-ditioning on the day of PCI,wherein the left and right upper arms were inflated to 200 mmHg with continuous pressure for 5 minutes using a blood pressure cuff.Additionally,during the PCI procedure,adenosine was administered to the experimental group at a rate of 50 μg/(kg·min)until the end of the procedure,with other treatments aligning with the conventional treatment group.Each patient received a coronary SYNTAXⅡscore.Resting D-SPECT and regadenoson stress D-SPECT were employed to evaluate total myocardial perfusion score,total myocardial ischemia segments,and left ventricular ejection fraction across 17 segment distributions before and 7 days after PCI.Results Before PCI,the differences in the number of myocardial ischemic segments,total myocardial perfusion score,and left ven-tricular ejection fraction between the two patient groups were not statistically significant(P>0.05).However,7 days post-PCI,compared with the conventional treatment group,the experimental group exhibited significantly improved numbers of myocardial ischemic segments,total myocardial perfusion score,and left ventricular ejection fraction(P<0.05).Furthermore,the differences in adverse drug reactions between the two patient groups were not statistically significant(P>0.05).Conclusion The combined application of remote ischemic preconditioning and adenosine injection in patients undergoing PCI is deemed safe and effective.